Hypotensive anaesthesia for microsurgery of the middle ear. A comparison between enflurane and halothane

Abstract

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.

Comparative evaluation between two methods of induced hypotension with infusion of Remifentanil and Labetalol during sinus endoscopy

“…Therefore, to cope with this problem, wide studies have been conducted in various parts of the world, and different methods have been suggested to overcome this problem that creation of controlled hypotension with using different drugs is one of these methods. [2] To create controlled hypotension (reduced systolic blood pressure to 80–90 mmHg or average arterial pressure to 50–60 mmHg) in the category of medications, a variety of drug such as inhaled anesthetics (halothane-isoflurane), vascular expanders (sodium nitroprusside and nitroglycerin), ganglion blockers (trimetaphan camsilate), beta and alpha-adrenergic blockers (phentolamine or labetalol), and the calcium channel blockers (nicardipine) are used. However, simultaneous use of them in some cases is not without risk and can cause a variety of cardiac arrhythmias such as ventricular fibrillation.…”

Nitroglycerine as a hypotensive agent in ear, nose, and throat surgery

“…Each patient must be titrated to the desired level of hemodynamic. At low doses of nitroglycerine (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) Med J Univ Indon to prevent coughing and straining with consequent bleed^i1e as a result of an increase in venous pressure.z'r The halothane 0.5 -1.0 vol % plus nitrousoxide-oxygen and pethidine was found to be satisfactory and gave an adequate depth of anesthesia.…”

Anaesthesia for major middle ear surgery

“…19 Conversely, normal arterial pressures do not always preclude an adequate field, and the surgeon's satisfaction with the field does not necessarily correlate with the systolic arterial pressure. 20 For these reasons the need for, and safety of, induced arterial hypotension has been a matter of ongoing debate. This is particularly so for procedures such as middle ear surgeries, where blood loss is minimal and there is no secondary gain of reducing transfusion requirements.…”