METHODS: A randomized controlled trial was conducted with 64 patients scheduled for tympanoplasty. Patients were randomly assigned to receive either 0.5-2 mg/min labetalol or 1.5 mg/kg/h lidocaine 1% to achieve controlled hypotension during surgery. The efficacy of the drugs was assessed by comparing the Mean Arterial Pressure (MAP), surgeon\'s satisfaction, time to target MAP, bleeding volume, postoperative pain scores, the need for analgesic medication in recovery, sedation, and other additional parameters.
RESULTS: The hemodynamic parameters showed a similar trend over time in both the labetalol and lidocaine groups. The median bleeding volume in the labetalol group (10 cc) was lower than that in the lidocaine group (30 cc), although this difference was not statistically significant (p = 0.11). Similarly, surgeon\'s satisfaction level, pain intensity, and sedation level in the recovery room did not show statistically significant differences between the two groups (p > 0.05). The duration of surgery, recovery stay, and extubation time also did not significantly differ between the groups. Both medications took approximately the same time (20 min) to reach the target MAP and exhibited comparable hemodynamic responses (p > 0.05).
CONCLUSIONS: Both labetalol and lidocaine effectively achieved controlled hypotension during tympanoplasty surgery, thereby improving surgical conditions. The choice of medication should be based on individual patient characteristics and the anesthesiologist\'s judgment.
METHODS: II.
方法:对64例计划进行鼓室成形术的患者进行了一项随机对照试验。患者被随机分配接受0.5-2mg/min拉贝洛尔或1%1.5mg/kg/h利多卡因,以在手术过程中实现控制性降压。通过比较平均动脉压(MAP)评估药物的疗效,外科医生的满意度,到达目标MAP的时间,出血量,术后疼痛评分,在恢复过程中需要镇痛药物,镇静,和其他附加参数。
结果:拉贝洛尔组和利多卡因组的血流动力学参数随时间的变化趋势相似。拉贝洛尔组的中位出血量(10cc)低于利多卡因组(30cc),尽管这种差异没有统计学意义(p=0.11)。同样,外科医生的满意度,疼痛强度,恢复室的镇静水平两组间差异无统计学意义(p>0.05)。手术的持续时间,恢复停留,拔管时间在两组间也无显著差异.两种药物花费大约相同的时间(20分钟)达到目标MAP,并且表现出相当的血液动力学反应(p>0.05)。
结论:拉贝洛尔和利多卡因在鼓室成形术中都能有效实现控制性降压,从而改善手术条件。药物的选择应基于患者的个体特征和麻醉医师的判断。
方法:II.