Comparative Study between Magnesium Sulfate and Lidocaine for Controlled Hypotension during Functional Endoscopic...

Area of Science:

• Anesthesiology
• Otolaryngology
• Surgical Oncology

Background:

• Intraoperative bleeding during functional endoscopic sinus surgery (FESS) compromises surgical field visibility.
• Controlled hypotension via anesthetic agents is a strategy to mitigate bleeding and enhance surgical exposure.
• Magnesium sulfate and lidocaine are explored for their hypotensive effects in FESS.

Purpose of the Study:

• To compare the efficacy of magnesium sulfate versus lidocaine in achieving controlled hypotension during FESS.
• To evaluate the impact of these agents on surgical field clarity and blood loss.
• To assess the influence on patient extubation time.

Main Methods:

• Prospective, randomized, double-blind clinical trial involving 80 adult patients (ASA Classes I-II, aged 20-50) undergoing FESS.
• Patients were randomized into two groups: one receiving lidocaine infusion, the other magnesium sulfate (bolus followed by infusion).
• Outcomes measured included surgical field quality, blood loss, extubation time, and hemodynamic parameters.

Main Results:

• Lidocaine group demonstrated significantly reduced blood loss (P=0.01) and superior surgical field clarity (P=0.002).
• Patients receiving lidocaine experienced significantly shorter extubation times (P=0.001).
• No significant hemodynamic differences were observed between the lidocaine and magnesium sulfate groups.

Conclusions:

• Both magnesium sulfate and lidocaine are effective in inducing controlled hypotension for FESS.
• Lidocaine offers advantages over magnesium sulfate, providing better surgical field exposure and faster extubation.
• Lidocaine is a favorable choice for optimizing surgical conditions and patient recovery in FESS.