The Effects of Oral Atenolol or Enalapril Premedication on Blood Loss and Hypotensive Anesthesia in Orthognathic Surgery
Yonsei Medical Journal
; : 1114-1121, 2015.
Article
em En
| WPRIM
| ID: wpr-150471
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WPRO
ABSTRACT
PURPOSE:
The aim of this study was to evaluate the effects of premedication with oral atenolol or enalapril, in combination with remifentanil under sevoflurane anesthesia, on intraoperative blood loss by achieving adequate deliberate hypotension (DH) during orthognathic surgery. Furthermore, we investigated the impact thereof on the amount of nitroglycerin (NTG) administered as an adjuvant agent. MATERIALS ANDMETHODS:
Seventy-three patients undergoing orthognathic surgery were randomly allocated into one of three groups an angiotensin converting enzyme inhibitor group (Group A, n=24) with enalapril 10 mg, a beta blocker group (Group B, n=24) with atenolol 25 mg, or a control group (Group C, n=25) with placebo. All patients were premedicated orally 1 h before the induction of anesthesia. NTG was the only adjuvant agent used to achieve DH when mean arterial blood pressure (MAP) was not controlled, despite the administration of the maximum remifentanil dose (0.3 microg kg-1min-1) with sevoflurane.RESULTS:
Seventy-two patients completed the study. Blood loss was significantly reduced in Group A, compared to Group C (adjusted p=0.045). Over the target range of MAP percentage during DH was significantly higher in Group C than in Groups A and B (adjusted p-values=0.007 and 0.006, respectively). The total amount of NTG administered was significantly less in Group A than Group C (adjusted p=0.015).CONCLUSION:
Premedication with enalapril (10 mg) combined with remifentanil under sevoflurane anesthesia attenuated blood loss and achieved satisfactory DH during orthognathic surgery. Furthermore, the amount of NTG was reduced during the surgery.Palavras-chave
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Assunto principal:
Piperidinas
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Pré-Medicação
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Atenolol
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Pressão Sanguínea
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Enalapril
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Débito Cardíaco
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Método Duplo-Cego
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Administração Oral
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Perda Sanguínea Cirúrgica
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Resultado do Tratamento
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Yonsei Medical Journal
Ano de publicação:
2015
Tipo de documento:
Article