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ORIGINAL RESEARCH

Effects of Esmolol Induced Hypotensive Anaesthesia on Distortion Product Otoacoustic Emission
Esmolol Kullanılarak Oluşturulan Hipotansif Anestezinin Distorsiyon Ürünü Otoakustik Emisyona Etkisi
Received Date : 09 Jan 2020
Accepted Date : 28 Feb 2020
Available Online : 11 Mar 2020
Doi: 10.24179/kbbbbc.2020-73483 - Makale Dili: EN
KBB ve BBC Dergisi. 2020;28(1):49-56
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The aim of this study is to investigate the effects of hypotensive anesthesia induced by esmolol on Distortion Product Otoacoustic Emission (DPOAE) and by this way its availability in cochlear monitoring. Material and Methods: This study, includes 25 patients between ages of 18-61 who were operated under general anesthesia. Bispectral Index (BIS) values were maintained in the 40-60 range by infusion of esmolol 50-300 mcg/kg/min, simultaneously with the induction of anesthesia. During surgery, esmolol infusion doses were set to maintain the mean arterial pressure (MAP) approximately 20% below the baseline. Hemodynamic and respiratory parameters and otoacoustic emission measurements were recorded at 0 min. before induction and 3 min., 10 min., and 20 min. after induction. Results: No statistically significant differences were observed in terms of DPOAE levels at 1500 Hz, 2000 Hz, 3000 Hz, 4000 Hz, 5000 Hz, and 6000 Hz. No statistically significant correlations were found between the changes of DPOAE levels and percentile changes of hemodynamic parameters according to the Bonferroni adjustment for 3 min., 10 min., and 20 min. time points when compared to zero minute time point. Conclusion: In this study, we found that esmolol-induced hypotensive anesthesia has no effect on the DPOAE response. This result is important in showing that the procedure we have been using in lateral skull base surgeries allow secure cochlear monitoring by providing hypotensive anesthesia.
ÖZET
Amaç: Bu çalışmanın amacı esmolol kullanılarak oluşturulan hipotansif anestezinin DPOAE (distorsiyon ürünü otoakustilk emisyon) yanıtlarına etkisini ve bu yolla koklear monitorizasyonda kullanılabilirliğini araştırmaktır. Gereç ve Yöntemler: Bu çalısma, genel anestezi altında opere edilen 18-65 yaş aralığında, 25 hastayı kapsamaktadır. 50-300 mcg/kg/dk esmolol infüzyonu anestezi indüksiyonuyla eşzamanlı uygulanarak, Bispectral Index (BIS) değeri 40-60 aralığında sürdürüldü. Ameliyat süresince, ortalama arter basıncı bazal değerin %20 altında olacak şekilde esmolol infüzyon dozları ayarlandı. Hemodinamik ve solunumsal parametreler ile otoakustik emisyon ölçümleri indüksiyon öncesi 0. dk, induksiyon sonrası 3. dk., 10. dk. ve 20. dk.’da kaydedildi. Bulgular: İzlem zamanları arasında 1500 Hz, 2000 Hz, 3000 Hz, 4000 Hz, 5000 hz, 6000 Hz’deki DPOAE düzeyleri yönünden istatistiksel olarak anlamlı farklılık görülmedi. Sıfırıncı dakikaya göre 3., 10., 20. dakikadaki DPOAE düzeylerindeki değişim ile hemodinamik ölçümlerde meydana gelen yüzdesel değişim miktarları arasında Bonferroni düzeltmesine göre istatistiksel olarak anlamlı korelasyon saptanmadı. Sonuç: Bu çalışmada esmolol kullanılarak oluşturulan hipotansif anestezinin DPOAE yanıtlarına etkisinin olmadığı saptanmıştır. Bu sonuç kullandığımız prosedürün lateral kafa tabanı cerrahilerinde hipotansif anestezi sağlayarak güvenli koklear monitorizasyona olanak vermesi açısından öneme sahiptir.
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