Controlled hypotension with desflurane combined with esmolol or dexmedetomidine during tympanoplasty in adults: A double-blind, randomized, controlled trial

Kol, İclal Özdemir; Kaygusuz, Kenan; Yıldırım, Ali; Doğan, Mansur; Gürsoy, Sinan; Yucel, Evren; Mimaroğlu, Caner

doi:10.1016/j.curtheres.2009.06.001

Cited by 26 publications

(24 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of 115 articles were retrieved from three databases After excluded duplicating, The remaining 75 articles were identi ed for further assessment. In the end, eight RCTs were included [8][9][10][11][12][13][14][15] .…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of the effects of dexmedetomidine vs esmolol for used controlled hypotension during surgery

Huang

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: At present ,the anesthetist usally use Controlled hypotension tecnical reduced blood loss and improved surgical field. Dexmedetomidine and esmolol have been proved effective for controlled hypotension. This meta-analysis aimed to evaluate the effects of dexmedetomidine versus esmolol on the controlled hypotension during surgery.Methods: All articles were retrieved from PubMed, Embase, Cochrane Library up to January 2020. JL and HD independently screened, extracted and evaluated the literature that meet the inclusion and exclusion criteria, and used RevMan 5.3 for statistic analysis.Results: Eight randomised trials, including 418 patients were selected in this meta-anaysis. And it’s results showed:1) The dexmedetomidine group was more favorable in reducing blood loss (MD 49.48 with 95% CI [-5.44,104.40], P =0.08）;2）Compared with the esmolol group，HR （MD 3.30 with 95% CI [2.11,4.50], P <0.00001）,requiring of fentany(SMD 5.96 with 95% CI [3.43,8.48], P <0.00001）were considerably lower in the dexmedetomidine group，while emergence time （MD -6.69 with 95% CI [-9.61,-3.76], P <0.0001)was more longer in the dexmedetomidine group . 3）Compared with the esmolol group，duration of surgery（MD -0.12 with 95% CI [-6.24,6.01], P = 0.97），MAP（ MD 2.29 with 95% CI [-2.02,6.60],P =0.30），the recovery period（MD -0.52 with 95% CI [-3.07,2.04], P = 0.69）were not statistically significant differences in the dexmedetomidine group.Conclusion: Two drugs were effective for controlled hypotension, but compared with esmolol, dexmedetomidine is more better in reducing blood loss ,and less requiring of fentanyl.But attention should be paid to the long emegence time and bradycardia.

show abstract

Section: Resultsmentioning

confidence: 99%

Meta-analysis of the effects of dexmedetomidine vs esmolol for used controlled hypotension during surgery

Huang

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The procedures related to ear are very sensitive to stimulations particularly during the surgery, so creating a setting with minimal movements is inevitable which requires relatively deep anesthesia. Various sedative and hypnotic drugs have been used in numerous studies for middle ear surgery to facilitate the operation till now [1,2,[6][7][8][9]. In recent years, it has been shown that intravenous administration of Propofol in middle ear surgery has led to better condition during operation [1].…”

Section: Discussionmentioning

confidence: 99%

Comparison the Effects of Infusion of Propofol -Remifentanil with Midazolam-Remifentanil in Reducing Bleeding in Patients undergoing Middle Ear Surgery

karv¹,

Ian²,

Davoodi³

et al. 2012

J Anesthe Clinic Res

View full text Add to dashboard Cite

Objective: This study compares the effects of infusion of Propofol-Remifentanil with Midazolam-Remifentanil in reducing bleeding in patients undergoing middle ear surgery. Methods: This study was conducted as a double blinded randomized clinical trial among 86 patients undergone elective surgery of the middle ear, they were divided in two 43 members group. All of the patients received Isoflurane and N 2 O as maintenance of general anesthesia. When entering the middle ear, in order to reduce bleeding and achieve surgeon's satisfaction, either the combination of Midazolam-Remifentanil (M-R) or the combination of Propofol-Remifentanil (P-R) was adjuvant in each group. The (M-R) group received 0.5-1 µg/kg/min Midazolam with intravenous infusion and (P-R) group received 50-100 µg/kg/min Propofol with intravenous infusion; 1.0 µg/kg/min Remifentanil was administered in both groups. Vital signs of the patients were measured and recorded in 5 minutes intervals during the surgical procedure. The BIS scores was monitored and recorded in each group. Satisfaction of the surgeon from surgical setting and the amount of bleeding was recorded based on the score 0-10. Results: There was no significant difference in systolic and diastolic blood pressure, mean arterial pressure (MAP), heart rate and BIS scores between the two groups during the procedure (P>0.05). Surgeon satisfaction showed no significant difference between the two groups (P>0.05). The differences between surgical procedure duration and period of PACU staying were statistically of no important significance between the two groups (P>0.05). Conclusion: It seems that in the middle ear procedures the combination of Propofol-Remifentanil and Midazolam-Remifentanil have not statistically significant differences in hemodynamic control, surgeon's satisfaction, duration of surgical procedure and discharge from PACU. Therefore, adjuvant drug selection might consider either of these two regimens in order to achieve better surgical condition. Further studies are recommended to confirm these findings. J o u rn al of A n e s th es ia & C li n ic a l Resea rc h

show abstract

“…Some of the studies shown that dexmedetomidine decreases the bleeding in surgeries with minimal hemodynamic alteration. [6,8,9,12] Nitroglycerin is a nitric oxide releaser which causes peripheral vasodilation by selectively dilating the venous capacitance vessels with reduction in venous return to the heart resulting in systemic hypotension. But there may be reflex tachycardia partially mitigating the beneficial effects of hypotension.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine Versus Nitroglycerine for Controlled Hypotension in Head & Neck Surgery: A Prospective Randomised Clinical Study

Kumar¹

2017

jmscr

View full text Add to dashboard Cite

Controlled hypotension with desflurane combined with esmolol or dexmedetomidine during tympanoplasty in adults: A double-blind, randomized, controlled trial

Cited by 26 publications

References 28 publications

Meta-analysis of the effects of dexmedetomidine vs esmolol for used controlled hypotension during surgery

Meta-analysis of the effects of dexmedetomidine vs esmolol for used controlled hypotension during surgery

Comparison the Effects of Infusion of Propofol -Remifentanil with Midazolam-Remifentanil in Reducing Bleeding in Patients undergoing Middle Ear Surgery

Dexmedetomidine Versus Nitroglycerine for Controlled Hypotension in Head & Neck Surgery: A Prospective Randomised Clinical Study

Contact Info

Product

Resources

About