87689
document
Metabolic and hormonal responses to induced hypotension for middle ear surgery . We have investigated in 30 patients the metabolic and hormonal responses to middle ear surgery using induced hypotension to a mean arterial pressure of 55 mm Hg . A standardized anaesthetic technique of propranolol , thiopentone-vecuronium-isoflurane was used in all patients and hypotension induced with sodium nitroprusside , trimetaphan camsylate or additional isoflurane . All patients showed a classic stress response with an increase in circulating blood glucose , cortisol and growth hormone concentrations . Blood lactate and plasma uric acid concentrations changed little during operation , suggesting that tissue oxygenation was adequate . However , the former declined after operation , possibly as a result of the concomitant use of propranolol . There were no significant differences between the three hypotensive techniques in their effects on the hormonal and metabolic response , although the increase in blood glucose concentration in the trimetaphan group was obtunded . We conclude that induced hypotension for middle ear surgery induced an endocrine and metabolic response of small magnitude and short duration .
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Intervention_Pharmacological
induced hypotension
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Intervention_Pharmacological
induced hypotension
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Intervention_Pharmacological
propranolol , thiopentone-vecuronium-isoflurane
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Intervention_Pharmacological
hypotension induced with sodium nitroprusside , trimetaphan camsylate or additional isoflurane
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Outcome_Adverse-effects
stress response
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Outcome_Physical
increase in circulating blood glucose
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Outcome_Adverse-effects
cortisol
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Outcome_Physical
growth hormone
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Outcome_Adverse-effects
concentrations
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Outcome_Physical
Blood lactate and plasma uric acid concentrations
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Outcome_Physical
blood glucose concentration
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Participant_Condition
middle ear surgery
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Participant_Sample-size
30
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Participant_Condition
hypotension