The aim of this study is to investigate the effects of the controlled hypotension provided by the use of remifentanil and esmolol on oxidative stress parameters during the middle ear and the nasal surgery.
This study was performed in patients who had planned to undergo elective septorhinoplasty. A total of 75 patients aged between 18 and 65 years who complied with the ASA I-II classification were included in this study. Patients were randomly divided into the following three groups: Group R (remifentanil group, n = 25); Group E (esmolol group, n = 25); and Group C (control, n = 25). In all patients, the induction of anesthesia was ensured with IV 2 mg.kg-1 propofol, 1 mcg.kg-1 fentanyl, and 0.6 mg.kg-1 rocuronium. Anesthesia was maintained through the inhalation of a mixture of 1 MAC sevoflurane and 60% nitrous oxide mixed with 40% oxygen
In the remifentanil group, MAP showed a greater decrease starting from the 25th minute after intubation compared to the control group. In the esmolol group, MAP showed a greater decrease starting from the 40th minute after intubation compared to the control group. In the remifentanil and control groups, there was a statistically significant decrease in the postoperative OSI levels compared to the preoperative levels. One the other hand, in the esmolol group, there was no statistically significant difference between the preoperative and postoperative median OSI levels. There was a significant increase in the postoperative TAL of the Remifentanil group compared to the preoperative level.
In conclusion, it was observed that during a hypotensive anesthesia induced by remifentanil or esmolol, remifentanil ensured more stable operating conditions in terms of hemodynamics compared with esmolol, and that remifentanil was also superior to esmolol in reducing oxidative stress.
Key words: total oxidant level, controlled hypotension, esmolol, remifentanil,General anesthesia
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