Comparative Analysis of Labetalol and Remifentanil for Inducing Hypotension in Oncological Patients Undergoing Functional Endoscopic Sinus Surgery

Abstract

Author(s): Sarah Adil Othman, Alyaa Hameed Saleh, Merwa Maher Sabah Rahdi, Saad Ahmed Ali Jadoo, Myasar Jasim Mohammed

Background: Surgical procedures involve head and neck had propensity to bleed because rich blood supply. Aim of study was to compare using labetalol and remifentanil to create controlled hypotension during Functional Endoscopic Sinus Surgery (FESS) among Iraq patients. Methods: In this prospective randomized clinical trial 40 patients underwent FESS under general anesthesia at Ghazi Al Harerri hospital, Baghdad Iraq. Patients were divided into two groups; the Labetalol Group (LG) received 20 mg bolus dose during 2 min followed by 0.5 mg/min-2 mg/min by infusion pump, and the Remifentanil Group (RG) received 0.5 mcg/kg/min -1 mcg/kg/min during 30 sec. Then infusion was given at rate of 0.25 mcg/kg/min-0.5 mcg/kg/ min. Hemodynamic parameters during anesthesia were measured, complication and surgeon satisfaction rate was recorded. Results: hemodynamic parameters are compared in both groups at different time of study [55 min duration of surgery]. The mean of systolic blood pressure are significant at min 55 when P value [0.002] and the mean of diastolic blood pressure are significant at min 10,15,55 when P value[0.03, 0.05,0.02] respectively while the mean of pulse rate was significant at min 45 when P value[0.05], the mean differences in mean arterial blood pressure was significant at min 55 when P value (0.001), but mean of ETCO2 and SPO2 are insignificant between groups. Surgeon satisfaction score is better in remifentanil group when P value [0.006] with less complication in the same group Conclusion: With infusion of labetalol and remifentanil, we can induce effective controlled hypotension with both drugs, but remifentanil as sole agent is better with short action and rapid recovery time and less complication with better surgeon satisfaction score over labetalol but economically labetalol is better.

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