A Comparison between Diltiazem and Nitroglycerine for Hypotensive Anaesthesia in Total Hip Arthroplasty.
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Date
2016-11
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Abstract
Background: To compare controlled induced hypotension for facilitating surgical exposure and reducing intraoperative
blood loss, using diltiazem and nitroglycerin in total hip arthroplasty under general anesthesia. Methods: 60 adults of
American Society of Anesthesiologists (ASA) grade I and II posted for total hip arthroplasty in the department of
orthopaedics were selected for prospective, randomized study and allocated randomly into three groups: Group A (control
group), group B (diltiazem-controlled hypotension), and group C (nitroglycerin-controlled hypotension).Statistical analysis
done using SPSS 20 software. Analysis of variance (ANOVA) test was used to compare the demographic data. Intergroup
comparison between A and B,B and C,A and C of the heart rate (HR) and mean arterial pressure (MAP)were done using
student t test. A P value <0.05 was considered significant. Results: The mean HR of group B showed a statistically
significant decrement which continued 30 min after stoppage of infusion compared to group A (p=0.001)and
C(p=0.001).The mean HR of group C showed a statistically significant increase upto the stoppage of infusion compared to
group A(P=0.001) and group B(P=0.001). MAP of group C (59.9+4.28)is decreased to the target MAP between 15 and
45min after starting infusion whereas group B (71.2+4.65)remained above target MAP even after 45min. Group B showed
a significant decrease in mean MAP (64.43+4.34)continuing upto 30 min after stoppage of infusion(p=0.001) compared to
group A(105.8+3.86) and group C(106.4+4.9). Conclusion: Diltiazem is a poor agent for the management of controlled
hypotension.
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Keywords
Diltiazem, hypotension, nitroglycerine, total hip arthroplasty
Citation
Nayak Kalyanibala, Mahapatra Ranjeeta, Nitha C S. A Comparison between Diltiazem and Nitroglycerine for Hypotensive Anaesthesia in Total Hip Arthroplasty. Annals of International Medical and Dental Research. 2016 Nov-Dec; 2(6): 16-19.