الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Aim of the work
The objective of this study was to compare the efficacy of magnesium sulphate and nitroglycerin in inducing hypotensive anesthesia and their effects on haemodynamics, visibility of the operative field and the intraoperative hemorrhage in patients scheduled for functional endoscopic sinus surgery (FESS) under general anesthesia.
Summary and conclusion
Induced hypotension is the elective lowering of arterial blood pressure by using different drugs and techniques. It is effective in decreasing blood loss and providing better visibility in the surgical field.
The aim of this study was to evaluate the effects of using magnesium sulphate versus nitroglycerin as a hypotensive agents on haemodynamic variables, amount of blood loss and quality of surgical field during FESS under general anesthesia.
This study was carried out in El-Minia University Hospital during the period from November 2006 to May 2007. The study involved forty adult patients of either sex, ASA physical status І and ІІ scheduled for elective FESS.
Patients were randomly allocated into two equal groups (20 patients each) according to the hypotensive agent which used.
Group I: Magnesium sulphate was administrated intravenously as a bolus dose of 40mg/kg before induction of general anesthesia, followed by continuous IV infusion (15mg/kg/hour) intraoperatively.
Group II: Nitroglycerin was administrated in a dose of 2μg/kg/minute during induction of anesthesia till achieved a target MAP (55-65mmHg) followed by a continuous IV infusion (1μg/kg/minute) intraoperatively.
Haemodynamic variables such as HR, SBP, DBP and O2 saturation were recorded at baseline preoperatively, after induction, 1, 5 min after intubation, and every 5min intraoperatively till the end of operation. The surgical field score was assessed (0-5) and intraoperative blood loss was estimated.
As regard heart rate changes, this study demonstrated that HR in nitroglycerin group was significantly higher than its corresponding reading in MgSo4 group at 5min intraoperatively and insignificant at all time points.
There were no statistical differences between the both groups in SBP, DBP, MAP and O2 saturation.
The surgical field score was better in nitroglycerin group in comparison to magnesium group without statistical difference.
There were no statistical differences between the both groups in recovery time from anesthesia.
The blood loss with nitroglycerin group was less than in magnesium group without statically difference.
Conclusion:
We concluded that a continuous IV infusion of nitroglycerin or magnesium sulphate by the dose mentioned above provides a satisfactory controlled hypotension and optimal operative conditions in patients undergoing FESS under general anesthesia. The use of nitroglycerin was associated with less blood loss and better operative field as compared to magnesium sulphate.