Comparison of Labetalol and Nitroglycerine,s Effects on Deliberate Hypotension in Septo-Rhinoplasty Ssurgery, a Randomized Clinical Trial

Abstract

Introduction:Bleeding during ENT surgeries may contribute to impaired view. The less blood in surgical filed, the better quality and more surgeon’s satisfaction is expected. Deliberate hypotension is a technique to achieve this goal. Current study aimed to evaluate effects of Labetalol andNitroglycerinein deliberate hypotension. Methods: It is a double blind RCT,conducted on 68 septo-rhinoplastypatients in ENT ward, Imam Reza Hospital, Mashhad, during 2017 after obtaining written consent. Patients were assigned to receive Nitroglycerine (n=32) or Labetalol (n=36) randomly. Mean arterial pressure and HR monitored. Total blood loss was estimated and recorded at a Boezaart Surgical Field Grading Scale. Surgeon’s satisfaction with surgical field condition was measured after the procedures using a questionnaire at a 5-point Likert scale. Results: Two studied groups were similar in demographic characteristics. Heart rate was lower in Labetalol group (P <0.001) significantly, but there was no significant difference between two groups regarding mean arterial pressure variations (P = 0.12). Surgeon’s satisfaction with the operation condition was not significantly different (P= 0.28). According to Boezaart scale, no statistically significant difference was found between groups with regard to bleeding volume (P= 0.75). Patients in Labetalol group received less additive drugs to maintain hypotension than another group (P=0.025). Conclusion: Although Labetalol and Nitoglycerine are not much different in reducing blood loss or providing a better view of surgical field but Labetalol is superior in maintaining heart rate and hypotension and noneed toadditive drug.