title: Comparative evaluation between two methods of induced hypotension with infusion of Remifentanil and Labetalol during sinus endoscopy.
abstract: OBJECTIVE
  This study aimed to compare two methods of controlled hypotension using labetalol and remifentanil in terms of capability to create controlled hypotension and to investigate the obtained complications, and satisfaction rate of surgeon and patient during functional endoscopic sinus surgery.
  
  
  METHODS
  In this prospective clinical trial, 62 patients underwent endoscopic sinus surgery in Al-Zahra and Ayatollah Kashani Hospitals of Isfahan were divided into two groups: in the first group, 20 mg bolus dose of labetalol and then infusion of it, at a rate of 0.5-2.0 mg/min and in the second group, remifentanil with dose of 0.5-1 μg/kg started and then 0.25-0.5 μg/kg/min were prescribed. Hemodynamic parameters during anesthesia and recovery time, surgeon and patient satisfaction, and recovery time were measured and recorded.
  
  
  RESULTS
  Hemodynamics variable were comparable between two groups at different times of the study. The mean of bleeding and the frequency of side effects were higher in labetalol group (P= 0.033 andP< 0.0001, respectively). The median of surgeon satisfaction score in remifentanil group was statistically higher in labetalol group (P< 0.0001). Recovery time, fluid requirement, and pain score in labetalol group reported significantly more than remifentanil group. Richmond Agitation-Sedation Scale status at time points in the postanesthetic care unit showed differences between groups.
  
  
  CONCLUSIONS
  With infusion of labetalol and remifentanil after a bolus dose we can induce effective controlled hypotension under general anesthesia. Remifentanil is a short-acting narcotic drug; then, patient satisfaction was better and recovery time was shorter. From the economic aspect, labetalol prefers to remifentanil.
authors.affiliation: Department of Anesthesia and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Sajedi
authors.affiliation: Department of Anesthesia and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Rahimian
authors.affiliation: Department of Anesthesia and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Khalili
keywords: Hypotension; Labetalol; Remifentanil; sinus endoscopy