Prospective randomized controlled study between gastrodin and remifentanil for controlled hypotension in endoscopic sinus surgery / 中国生化药物杂志

ABSTRACT

Objective To compare the changes in postoperative pain, complications and clinical effect between gastrodin and remifentanil for controlled hypotension in endoscopic sinus surgery.Methods Eighty patients undergoing endoscopic sinus surgery were enrolled in the study.Patients were randomized into two groups of 40 to receive gastrodin (Group G) or remifentanil (Group R) infusion.Two groups were administered with propofol of 2 mg/kg to induce anaesthesia, which was maintained using sevoflurane.Group R received a continuous infusion of remifentanil titrated between 3 and 4 ng/mL using target-controlled infusion, whereas Group G received an i.v.gastrodin bolus of 2 mg/kg followed by a 20 mg/kg continuous infusion to maintain a mean arterial pressure ( MAP) between 60 and 70 mmHg.Haemodynamic variables, surgical conditions, postoperative pain, and adverse effects, such as postoperative nausea and vomiting ( PONV) and shivering were recorded.Results Controlled hypotension was well maintained in both groups.MAP and heart rate were higher in Group R than Group G after operation(P<0.05).Surgical conditions scores were not different between two groups.Postoperative pain scores were significantly lower in Group G than Group R (P<0.05).Shivering and the use of antiemetic and analgesic drugs were also less frequent in Group G than Group R (P<0.05).Conclusions Both gastrodin and remifentanil when combined with sevoflurane provides adequate controlled hypotension and proper surgical conditions for endoscopic sinus surgery.However, patient administered gastrodin has a more favourable postoperative course with better analgesia and less shivering and PONV.