• Nagat S El-Shmaa, EzzHoda Alsaid AhmedHAADepartment of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University, Egypt., and Ahmed Younes.
• Department of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University, Egypt.
• J Clin Anesth. 2017 Jun 1; 39: 154-158.

ObjectiveTo assess the efficacy of labetalol versus nitroglycerin for induction of controlled hypotension during sinus endoscopic surgery.DesignA prospective, double-blind and randomized study.SettingCarried out in operating room in university hospital.Patients60 patients of both sexes, American Society of Anesthesiologists (ASA) physical status I and II, age range from 20 to 60years; scheduled for elective sinus endoscopic surgery under general anesthesia (GA).InterventionsPatients were divided into two groups (30 each). NTG group received nitroglycerin infusion at a dose of 2-5μg/kg/min, LAB group received labetalol infusion at a dose of 0.5-2mg/min.MeasurementsSurgical condition was assessed by surgeon using average category scale (ACS) of 0-5, a value of 2-3 being ideal. In both groups mean arterial blood pressure (MAP) was gradually reduced till the ideal ACS for assessment of surgical condition, the target of ACS was 2-3 or lower.ResultsBoth studied drugs achieved desired hypotension and improved visualization of surgical field by decreasing bleeding in the surgical site, but ideal surgical conditions were created at mild hypotension (MAP 70-75) in LAB group while same conditions were created at MAP of 65-69mmHg in NTG group. Mean heart rate (HR) was significantly higher in NTG group as compared to LAB group. Blood loss decreased significantly in LAB group.ConclusionBoth labetalol and NTG are effective and safe drugs for induction of controlled hypotension during sinus endoscopic surgery. While, labetalol was better as it offered optimum operative condition with mild decrease in blood pressure, decreased surgical bleeding and less tachycardia during the surgery.Copyright © 2017 Elsevier Inc. All rights reserved.

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