Sarcouncil Journal of Medical Sciences

Abstract: Objective: To evaluate the clinical efficacy of remifentanil infusion in comparison with nitroglycerine regarding controlled hypotension during rhinoplasty. Background: Controlled hypotension is a well-known technique used in many operations to reduce blood loss and need for blood transfusion and to provide satisfactory bloodless surgical field. Many Drugs are used to preform controlled hypotension intra-operatively. Patients and Methods: A total of 120 adult consented patients of both genders undergoing rhinoplasty aged (20-50) years with ASA I or II, were randomized to receive remifentanil infusion (0.3 – 0.5) µg/Kg/min. (group 1 = 60 patients) or nitroglycerine (1) µg/Kg/ min. (group 2 = 60 patients) intraoperatively with adjusting dose till reaching target MAP around 60 mm Hg. Anesthetic Technique was standard for both groups . Time to onset of induced hypotension and Time to Target MAP were recorded in addition to heart rate during induced hypotension, PaO2, PCO2 and pH Together with the total infusion dose of the hypotensive agents in both groups. Results: Remifentanil infusion intraoperatively induces adequate hypotension with no statistical significant difference to that induced by nitroglycerine. Conclusion: This study confirmed that remifentanil infusion with dose of (0.3 – 0.5) µg/Kg/min. Induced desired controlled hypotension intraoperatively during rhinoplasty with no complications occurred either intra or postoperative with advantage of rapid recovery from anesthesia.