Use of remifentanil in comparison with sodium nitroprusside for controlled hypotension during rhinoplasty: Randomized controlled trail

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• 作者：Eman Mohammed Kamal Aboseif ; Sameh Mohammed Osman
• 关键词：Remifentanil ; Sodium nitroprusside ; Controlled hypotension ; Rhinoplasty
• 刊名：Egyptian Journal of Anaesthesia
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：31
• 期：4
• 页码：303-308
• 全文大小：1038 K

文摘

To evaluate the clinical efficacy of remifentanil infusion in comparison with sodium nitroprusside regarding controlled hypotension during rhinoplasty.

Background

Controlled hypotension is a well-known technique used in many operations to reduce blood loss and need for blood transfusion and to provide satisfactory bloodless surgical field. Many pharmacological agents are used to perform controlled hypotension intraoperatively.

Patients and methods

A total of 130 adult consented patients of both sexes undergoing rhinoplasty aged 20–45 years with ASA I or II, were randomized to receive remifentanil infusion 0.25–0.5 渭g/kg/min (group I = 65 patients) or sodium nitroprusside 0.5 渭/kg/min intraoperatively with adjusting dose till reaching target MAP around 80 mmHg. Anesthetic technique was standard for both groups. Time to onset of induced hypotension and time to target MAP were recorded in addition to heart rate during induced hypotension, PaO₂, PCO₂ and PH together with the total infusion dose of the hypotensive agents in both groups.

Results

Remifentanil infusion intraoperatively induces adequate hypotension with no statistical significant difference to that induced by sodium nitroprusside (P < 0.05).

Conclusion

This study confirmed that remifentanil infusion with dose of 0.25–0.5 渭g/kg/min. induced desired controlled hypotension intraoperatively during rhinoplasty with no complications occurred either intra- or postoperative with advantage of rapid recovery from anesthesia.