Comparison of esmolol versus magnesium sulfate for inducing controlled hypotension for functional endoscopic sinus surgery: a randomized double blinded interventional study
Keywords:Esmolol, Magnesium sulfate, Controlled hypotension, FESS, Surgical field visibility
Background and Aims: Excessive bleeding during Functional endoscopic sinus surgery (FESS) can lead to poor visibility of surgical field which can be improved by controlled hypotension. Aim of this study was to compare hypotensive properties of esmolol and magnesium sulfate and to compare quality of surgical field during FESS.
Methods: A hospital based prospective randomized double blinded interventional study in which 130 patients undergoing FESS randomly allocated to two equal groups. Group A received inj. Esmolol 1mg/kg bolus diluted to 10ml in saline and maintenance infusion at 1mg/kg/hr. Group B received inj. Magnesium Sulfate 40mg/kg bolus in 10ml of saline followed by 15mg/kg/hr infusion. Hemodynamic parameters, quality of the surgical field (average category score), amount of blood loss, emergence time, time to first analgesic request and postoperative sedation were recorded. Outcome was analysed using appropriate statistical test. P value <0.05 was considered statistically significant.
Result: Mean Heart Rate and Mean Arterial Pressure were statistically significantly lower in group A compared to group B at all time intervals (P=0.001). Surgical field quality was found better in group A. Emergence time, postoperative sedation score and time to first analgesic request were significantly more in group B.
Conclusion: Esmolol provides comparatively better surgical field and better hemodynamic stability over magnesium sulfate without any significant side effect. Magnesium sulfate provides additional benefit of postoperative analgesia and sedation.
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Copyright (c) 2023 Neelam Charan, Satveer S Gurjar, Nisha Kanwar, Bafna Usha
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