Document Type : Original Article
Authors
1
Anesthesia&ICU department,Faculityof Medicine,Assiut Univerisity,Egypt.
2
Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Egypt
3
Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Assiut University, Egypt.
4
Department of Ear, Nose, and Throat Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
Abstract
Background:
Intraoperative bleeding is thought to be a significant barrier to endoscopic vision. Blood obstructs the surgical field's anatomy and stains the endoscope lens, making visibility more challenging. The likelihood of consequences, such as brain injuries, orbital or optic nerve damage, and catastrophic haemorrhage from significant arteries, is increased in this circumstance.
Objectives:
To investigate the effects of adding verapamil and bisoprolol to general anaesthetic to reduce heart rate and blood loss at endoscopic sinus surgery, to explore the surgeon's evaluation of the surgical field and hemodynamics, and to investigate the effects of adding verapamil and diltiazem to general anaesthetic to investigate serum cortisol and norepinephrine levels at endoscopic sinus surgeries.
Patients and methods:
This quasi-experimental investigation was conducted at Assiut University Hospital. A convenience sample of 135 adult patients, both males and females, was divided into three equal groups: the control group (45 patients), who were given a placebo orally (PO) three hours before surgery; the Bisoprolol group (45 patients), who were given Bisoprolol 10 mg PO preoperatively; and the verapamil group (45 patients), who were given 80 mg PO of verapamil three hours before surgery. The primary goal was to determine how adding oral verapamil or Bisoprolol to general anaesthesia affected intraoperative hemodynamics and blood loss during endoscopic sinus surgery. The secondary goal was to determine how adding oral verapamil or Bisoprolol to general anaesthetic affected serum cortisol and norepinephrine levels throughout endoscopic sinus surgeries and the surgeon's evaluation of the surgical field.
Results:
The three investigated groups showed statistically substantial differences in the mean heart rate, mean systolic blood pressure, and blood loss at various intraoperative times. Groups 1 and 2 (p< 0.001), 2 and 3 (p <0.001), and 1 and 3 (p <0.001) all showed statistically substantial differences.
Conclusion: Verapamil and Bisoprolol are reliable and secure medications for this use. However, Bisoprolol was superior since it allowed for ideal surgical conditions while slightly lowering blood pressure. Additional benefits included decreased intraoperative bleeding and tachycardia during the procedure.
Keywords
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