Summary
Fifty patients undergoing microsurgery of the ear were anaesthetised using thiopentone, nitrous oxide, oxygen and either halothane or isoflurane, via a low flow circle system with carbon dioxide absorption. Systolic blood pressure was reduced to approximately 70 mmHg by the additional use of increments of labetalol; the patients breathed spontaneously. The degree of haemostasis was assessed by the surgeon who was unaware which volatile agent was being used to supplement anaesthesia. Isoflurane, although it is a potent vasodilator produced operating conditions which were indistinguishable from halothane. Isoflurane is thus a safe and reliable alternative to halothane as a volatile agent used to supplement anaesthesia when using induced hypotension for middle ear surgery.
The surgical nursing staff at Quccn Mary's Hospital for Children deserve much thanks for their work with the recovery charts. We arc gratcful to Mr U.M. Forrest The ejjicncy ofhulothane und enflurune in producing good operating conditions U U S comparcd during this trchniyuc.. Huemostasis was assessed b, v the surgeon who was unaware which volatile agent was being used. Both agents uere found to be satisfactory and enflurune was shown to be a safe and reliable agent with this technique should an nlremariw to halothanr be required. No impairment of renalfunction was seen with either agent in combination with hypoten.sion.
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