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
Elif ERSOY ÇALLIOĞLUa, Ebru SALMANB, Öznur DOĞANB, Ali Sami BERÇİNC,
Halil İbrahim MİŞEa, Mustafa AKSOYd, Muzaffer KİRİŞc, Fatma BERÇİNb,
Mehmet Hakan KORKMAZc
aAnkara City Hospital, Department of Otolaryngology, Ankara, TURKEY
bAnkara City Hospital, Department of Anesthesiology and Reanimation, Ankara, TURKEY
cYıldırım Beyazıt University Faculty of Medicine, Department of Otolaryngology, Ankara,T URKEY
dYıldırım Beyazıt University Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, TURKEY
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.
Keywords: Esmolol; anesthesia; otoacoustic emission
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.
Anahtar Kelimeler: Esmolol; anestezi; otoakustik emisyon
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