Objective: To compare the effects of esmolol and remifentanil, used as adjuncts for induced hypotension on surgical conditions and short-term cognitive functions, during tympanoplasty.
Methods: The study was conducted in Hacettepe University, School of Medicine, Ankara, Turkey between January 2005 and December 2006 following Institutional Ethical Committee approval, 40 ASA I-II patients, between 18 and 60 years of age were included in this study. With the induction of anesthesia, for group E, an esmolol infusion of 50-250 ug.kg-1.min-1 was titrated, following a bolus of 0.5 mgxkg-1; for group R, a remifentanil infusion of 0.2-0.5 ugxkg-1xmin-1 was titrated; to achieve a mean blood pressure (BP) of 55-65 mm Hg. Arterial BP were recorded continuously throughout the operation. Mini Mental State Test (MMS) was performed at the preoperative 30th minute (MMSP), postoperative 30th minute (MMS30), 60th minute (MMS60) and 24th hour (MMS24). Surgical field was evaluated by the blinded surgeon, using a 6 point category scale.
Results: Patient demographics were similar in both groups. Sustained controlled hypotension was sufficient in all of the groups throughout surgery. Surgical field scores were lower in group R (p<0.05), although the scores were
Conclusion: Remifentanil or esmolol provided adequate induced hypotension and similar operating conditions and their effects on cognitive functions in the short postoperative period are similar for tympanoplasty.
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