Document Detail

Comparison between prostaglandin E1, and esmolol infusions in controlled hypotension during scoliosis correction surgery a clinical trial.
MedLine Citation:
PMID:  23327033     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: scoliosis correction surgery is common in children, and adolescents. Deliberate hypotension is indicated in scoliosis correction procedures, because bloodless field is needed for exposure of the nerve roots, and to decrease the need for blood transfusion. Protection of the kidneys during deliberate hypotension is essential. The ideal hypotensive drug maintains the renal function and the urine output during the period of hypotension. Aim of this study is to compare Prostaglandin E1, and Esmolol hypotensive effects, bleeding score, and their effects on the serum creatnine, and urine output.
PATIENTS AND METHODS: Twenty patients under went hypotensive anesthesia during scoliosis correction procedure, were enrolled in this clinical trial. In group 1 (n = 10) (Esmolol infusion), group 2 (n = 10) (prostaglandin E1 infusion), Parameters were measured: Mean arterial blood pressure, Heart rate, (preoperative, just after induction, 15 minutes, 30 minutes, 60 minutes after starting the infusions, and 15 minutes after discontinuation of infusions). The bleeding score was assessed at (15 minutes, 30 minutes, 60 minutes after starting the infusions).
RESULTS: heart rate was significantly higher in prostaglandin E1 group than Esmolol group at 15, 30, 45, and 60 minutes. There was significant difference in the bleeding score only after 30 minutes, The target mean blood pressure (50 mmHg) was achieved at 30 minutes in group 2 (prostaglandin E1), while it was achieved at 60 minutes in group 1 (Esmolol group). There were significant differences in Mean blood pressure between both groups at 15, 30, 45, 60 minutes after starting the infusions. Creatnine level was significantly lower in prostaglandin E1 group, while the introperative urine output was significantly higher in prostaglandin E1 group.
CONCLUSIONS: Prostaglandin E1 hypotensive effects started earlier than Esmolol and its bleeding score is better than esmolol especially at thirty minutes after initiation of the infusion. Prostaglandin E1 can maintain renal function and urine output more than Esmolol. This study recommended using Prostaglandin E1 to induce hypotensive anesthesia in scoliosis correction
Hala Mostafa Goma
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Middle East journal of anaesthesiology     Volume:  21     ISSN:  0544-0440     ISO Abbreviation:  Middle East J Anaesthesiol     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2013-01-18     Completed Date:  2013-02-18     Revised Date:  2014-10-10    
Medline Journal Info:
Nlm Unique ID:  8604187     Medline TA:  Middle East J Anaesthesiol     Country:  Lebanon    
Other Details:
Languages:  eng     Pagination:  599-604     Citation Subset:  IM    
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MeSH Terms
Adrenergic beta-1 Receptor Antagonists / administration & dosage,  therapeutic use
Alprostadil / administration & dosage*,  therapeutic use
Blood Pressure / drug effects
Creatinine / blood
Heart Rate / drug effects
Hypotension, Controlled / methods*
Propanolamines / administration & dosage*,  therapeutic use
Scoliosis / surgery*
Time Factors
Vasodilator Agents / administration & dosage,  therapeutic use
Reg. No./Substance:
0/Adrenergic beta-1 Receptor Antagonists; 0/Propanolamines; 0/Vasodilator Agents; AYI8EX34EU/Creatinine; F5TD010360/Alprostadil; MDY902UXSR/esmolol

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