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A Comparison of the Effects of Esmolol and Dexmedetomidine on theClinical Course and Cost for Controlled Hypotensive Anaesthesia     
Yazarlar
Doç. Dr. Zeynel Abidin ERBESLER Doç. Dr. Zeynel Abidin ERBESLER
Ahi Evran Üniversitesi, Türkiye
Bakan Nurten
Yilmaz Karaoren Gulsah
Erkmen Muhammet Ali
Özet
Objective: We aimed to compare the effects of esmolol (ß-blocker) and dexme-detomidine (α-2-agonist) on patients' clinical course and cost for controlled hypotension during middle-ear surgery. Methods: Fifty patients with ASA I-II scheduled for tympano-mastoidectomy were enrolled in the study and randomized into 2 similar groups. Bispectral Index (BIS)and neuromuscular monitoring (TOF GUARD-SX) were applied to all patients. In group E (n=25), 0.5 mg kg-1 min-1 esmolol was infused over 1 min before induction and titrated over a range of 10200 μg kg-1 min-1; in group D (n=25), 0.5 μg kg-1 dexmedetomidine was infused over 10 minutes before induction, and then titrated over a range of 0.2-0.7 μg kg-1 hr-1 to maintain mean arterial pressure (MAP) between 55 and 65 mmHg after induction. In both groups, 0.25 μg kg-1 min-1 remifentanil infusion was used for maintenance with 1 MAC sevoflurane in 50% O2+50% air mixture so that BIS was kept between 40 and 50. In both groups, effects on haemodynamics (heart rate (HR), mean arterial pressure (MAP)), neuromuscular blockage (onset of action (OA), duration of clinical action (DCA), recovery index (RI)), bleeding score, surgeon satisfaction, and the total quantity of dexmedetomidine and esmolol doses were recorded and the costs were compared. Results: No significant difference was present in haemodynamics, bleeding scores or surgeon satisfaction between groups. Although OA was similar in both groups, DCA and RI were significantly higher in group D. Cost was significantly higher with esmolol than dexmedetomidine. Conclusion: We conclude that both agents are feasible. However, a prolongation in neuromuscular block time was found with dexmedetomidine, while higher costs were observed with esmolol. © 2013 by Turkish Anaesthesiology and Intensive Care Society.
Anahtar Kelimeler
Anesthesia | Controlled hypotension | Dexmedetomidine | Esmolol | Middle ear surgery
Makale Türü Özgün Makale
Makale Alt Türü ESCI dergilerinde yayımlanan tam makale
Dergi Adı Turkish Journal of Anesthesia and Reanimation
Dergi ISSN 1304-0871
Dergi Tarandığı Indeksler ESCI: Emerging Sources Citation Index
Makale Dili İngilizce
Basım Tarihi 10-2013
Cilt No 41
Sayı 5
Sayfalar 156 / 161
Doi Numarası 10.5152/TJAR.2013.36
Makale Linki http://www.jtaics.org/jvi.aspx?pdir=tardplng=engun=TARD-86570look4=