Effect assessment of controlled hypotension of remifentanil in endoscopic sinus surgery

Abstract

Objective To investigate the effects,safety,controlling of controlled hypotension induced by remifentanil during endoscopic sinus surgery.Methods Forty patients with ASA grade Ⅰ～Ⅱ undergoing selective endoscopic sinus surgery,were randomly assigned into remifentanil group(A group)and nitroglycerin group(B group).After routine inducing,controlled hypotension was induced before the main procedure of surgery.A group was given remifentanil(1μg/kg)by intravenous injection,then remifentanil(0.3～0.8μg·kg~(-1)·min~(-1))was used in group A to keep mean arterial pressure between(MAP)60 and 80 mm Hg.B group was given fentanyl(0.03～0.08 μg·kg~(-1)·min~(-1))and nitroglycerin(2～5 μg·kg~(-1)·min~(-1))to keep mean arterial pressure(MAP)between 60 to 80 mm Hg till the main procedure of surgery was finished.Observing MAP and HR change before controlled hypotension,during controlled hypoteusion and after stopping controlled hypotension.Observing the time of opening-eyes,remove-tracheal tube and surgical field quality.Results The two groups were comparable with regard to the surgical field rating(P＞0.05).MAP in two groups during controlled hypotension were lower than those before controlled hypotension(P＜0.05),in A group,MAP were comparable with those in B group during controlled hypotension(P＞0.05).In B group there was rellexible tachycardia during controlled hypotension.HR in A group during controlled hypotension was lower than those before controlled hypotension(P＜0.05).HR during controlled hypotension in A group was lower than those in B group(P＜0.01).The time of opening-eyes,remove-tracheal tube in A group was less than those in B group(P＜0.01).ConclusionRemifentanil cound induce and sustain controlled hypoteusion.It was safe and feasible.It was better than nitroglycerin group for controlled hypotension in endoscopic sinus surgery. Key words: fentanil; hypotension controlled