Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery
Background Reflex tachycardia that occurs during nitroglycerin-induced hypotensive anesthesia in functional endoscopic sinus surgery (FESS) increases both the risk of intraoperative bleeding and the duration of surgery. Our clinical trial aimed to compare the effect of oral ivabradine versus oral pr...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2131350 |
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| author | Mostafa Abdallah Lotfy Mohamed Raafat Abdelazim Hammad Heba Abdelazim Labib Hany Attia Abdelgalial Ahmed Moustafa Mohamed |
| author_facet | Mostafa Abdallah Lotfy Mohamed Raafat Abdelazim Hammad Heba Abdelazim Labib Hany Attia Abdelgalial Ahmed Moustafa Mohamed |
| author_sort | Mostafa Abdallah Lotfy Mohamed |
| collection | DOAJ |
| description | Background Reflex tachycardia that occurs during nitroglycerin-induced hypotensive anesthesia in functional endoscopic sinus surgery (FESS) increases both the risk of intraoperative bleeding and the duration of surgery. Our clinical trial aimed to compare the effect of oral ivabradine versus oral propranolol as a premedication before nitroglycerin-induced hypotensive anesthesia on the reduction of reflex tachycardia in FESS.Methods In this clinical, comparative, prospective, randomized, controlled, double-blinded study, 40 patients were divided into two equal groups (20 each); group P received oral propranolol (10 mg tablet) and group I received oral ivabradine (5 mg tablet) in the evening before the surgery and 1 hour before the induction of anesthesia.Results The reduction in heart rate (HR) was statistically significantly higher in group I than in group P. Conversely, the reduction in mean blood pressure (MAP) was statistically significantly higher in group P than in group I at baseline (pre-induction). However, after that, MAP reduction was statistically non-significant between both groups. Meanwhile, there was no statistically significant difference between both groups as regards duration of surgery, duration of deliberate hypotension, intraoperative NTG infusion doses, and the amount of bleeding.Conclusion Premedication with oral propranolol 10 mg or oral ivabradine 5 mg before FESS proved to be safe and effective in the reduction of reflex tachycardia that occurs during controlled nitroglycerin induced hypotensive anesthesia in FESS. However, ivabradine was more effective with higher safety profile than propranolol. |
| first_indexed | 2024-04-13T19:54:51Z |
| format | Article |
| id | doaj.art-ac246dde8b0640e7b5fb7c100678f4dc |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-13T19:54:51Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-ac246dde8b0640e7b5fb7c100678f4dc2022-12-22T02:32:22ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138157257910.1080/11101849.2022.2131350Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgeryMostafa Abdallah Lotfy Mohamed0Raafat Abdelazim Hammad1Heba Abdelazim Labib2Hany Attia Abdelgalial3Ahmed Moustafa Mohamed4Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University Cairo EgyptDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University Cairo EgyptDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University Cairo EgyptDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University Cairo EgyptDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University Cairo EgyptBackground Reflex tachycardia that occurs during nitroglycerin-induced hypotensive anesthesia in functional endoscopic sinus surgery (FESS) increases both the risk of intraoperative bleeding and the duration of surgery. Our clinical trial aimed to compare the effect of oral ivabradine versus oral propranolol as a premedication before nitroglycerin-induced hypotensive anesthesia on the reduction of reflex tachycardia in FESS.Methods In this clinical, comparative, prospective, randomized, controlled, double-blinded study, 40 patients were divided into two equal groups (20 each); group P received oral propranolol (10 mg tablet) and group I received oral ivabradine (5 mg tablet) in the evening before the surgery and 1 hour before the induction of anesthesia.Results The reduction in heart rate (HR) was statistically significantly higher in group I than in group P. Conversely, the reduction in mean blood pressure (MAP) was statistically significantly higher in group P than in group I at baseline (pre-induction). However, after that, MAP reduction was statistically non-significant between both groups. Meanwhile, there was no statistically significant difference between both groups as regards duration of surgery, duration of deliberate hypotension, intraoperative NTG infusion doses, and the amount of bleeding.Conclusion Premedication with oral propranolol 10 mg or oral ivabradine 5 mg before FESS proved to be safe and effective in the reduction of reflex tachycardia that occurs during controlled nitroglycerin induced hypotensive anesthesia in FESS. However, ivabradine was more effective with higher safety profile than propranolol.https://www.tandfonline.com/doi/10.1080/11101849.2022.2131350Ivabradinepropranololnitroglycerinecontrolled (deliberate) hypotensive anesthesiaFESS |
| spellingShingle | Mostafa Abdallah Lotfy Mohamed Raafat Abdelazim Hammad Heba Abdelazim Labib Hany Attia Abdelgalial Ahmed Moustafa Mohamed Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery Egyptian Journal of Anaesthesia Ivabradine propranolol nitroglycerine controlled (deliberate) hypotensive anesthesia FESS |
| title | Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery |
| title_full | Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery |
| title_fullStr | Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery |
| title_full_unstemmed | Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery |
| title_short | Comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery |
| title_sort | comparing the effect of oral ivabradine versus oral propranolol premedication during controlled hypotensive anesthesia in functional endoscopic sinus surgery |
| topic | Ivabradine propranolol nitroglycerine controlled (deliberate) hypotensive anesthesia FESS |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2131350 |
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