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Original Research

Ann Med Res. 2004; 11(4): 237-241


Controlled Hypotension with Dexmedetomidine for Middle Ear Surgery

M. Hacer Ülger*, Semra Demirbilek*, Ahmet Köroğlu*, Hale Borazan*, M.Özcan Ersoy*

.




Abstract


Aim: To compare the effect of dexmedetomidine on providing controlled hypotension and surgical field quality,

liver and kidney function in middle ear microsurgery, with nitroglycerine.

Material and Method: Patients were divided into two groups after anesthetic induction with thiopental (5-7 mg. kg-

1), fentanyl (1 μg. kg-1), and vecuronium (0.1 mg. kg-1). In dexmedetomidine group (n=20), following the loading

dose of 1 μg. kg-1 (10 min), infusion was applied with a dose of 0.1-0.7 μg.kg-1.h-1. In nitroglycerine group (n=20),

infusion of nitroglycerine was applied with a dose of 0.25-1 μg.kg-1.min-1. Drug doses were titrated to maintain the

mean arterial pressure (MAP) at 65-75 mmHg. Anesthesia was maintained with 4-6 % desflurane and 60% oxygenair

mixture. During controlled hypotension, arterial blood gas analysis was examined. For the measurement of AST,

ALT, BUN and creatinine, blood samples were obtained before and after surgery and on postoperative third day.

Results: Fifteen minutes after controlled hypotension and immediately after the extubation, MAP and HR were

higher in nitroglycerine group (95.15 ±16.88 and 96.10 ± 22.76, respectively) when compared with

dexmedetomidine group (84.90 ± 14.26 and 82.65 ± 18.82, respectively). In dexmedetomidine group, 15 min after

controlled hypotension, MAP was higher compared to the value previous to induction (p






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