A randomised comparative study of desflurane and sevoflurane with esmolol to evaluate hemodynamic parameters and recovery characteristics in middle ear surgery

Abstract

To produce a blood less field for middle ear surgery performed with operating microscope, controlled hypotention is essential which achieve by means of Inhalational agents and Esmolol.The goal of the study was to assess the effects of Desflurane and Sevoflurane vs esmolol in terms of creating controlled hypotension, intraoperative blood loss, surgeon satisfaction with the surgical field, and complications. From December 2019 to July 2021, a prospective, randomised, double-blind trial was undertaken. A total of 100 patients, ranging in age from 18 to 60 years, were recruited and had elective middle ear procedures in the Department of Oto-rhino-laryngology operating theatre. Simple randomization (computer-generated) was used to divide the patients into two groups: Group S and Group D. Inj. Esmolol 0.5 mg/kg was administered as a loading dose, followed by a continuous infusion, and Propofol 2 mg/kg was used to produce anaesthesia. Inj. Vecuronium (0.1mg/kg) was administered to help with laryngoscopy and intubation. Oxygen, Nitrous oxide, Sevoflurane 1-3 percent (Group S) or Desflurane 3-6 percent (Group D) and intermittent InjVecuronium (0.05 mg/kg) were used to maintain anaesthesia. Intraoperative haemodynamics, six-point bleeding score, surgeon satisfaction, and postoperative Aldrete recovery score were all observed. Microsoft Excel was used to input and evaluate the data.When comparing Group S to Group D, haemodynamic measures were significantly different (p value 0.05). When comparing Group S to Group D, the six-point bleeding score and surgeon satisfaction score were considerably higher in Group S (p value 0.05). Within 5 minutes of surgery, 100% of patients in Group D and 76% of patients in Group S had achieved an aldrete score of 9,10.In middle ear surgery, sevoflurane produces more controlled hypotension. When compared to the Desflurane group, the sevoflurane group had superior surgical field vision and a higher surgeon satisfaction score. When compared to the Sevoflurane group, the Desflurane group had a superior post-operative Aldrete recovery score.