Comparison of the Effect of Remifentanil and Nitroglycerin on Intraoperative Blood Pressure and Intraoperative and Postoperative Complications during Rhinoplasty: Care and Prevention

Hemodynamic changes are one of the most important risk factors for complications in rhinoplasty. The aim of this study was to compare the effect of remifentanil and nitroglycerin on intraoperative blood pressure and other complications during and after rhinoplasty in surgical center.

This was a quasi-experimental double-blind study performed on patients referred to Imam Ali Clinic of Shahrekord University of Medical Sciences, Iran, for rhinoplasty in year 2017. 50 rhinoplasty candidates with class one and two American Society of Anesthesiologists (ASA) were randomly divided into two groups of 25. Simultaneously, with the administration of anesthesia in the first group, remifentanil (0.1-0.3 μg/kg/minute) and in the second group, nitroglycerin (0.5-1 μg/kg/minute) were administered. During the surgery, heart rate, bleeding, systolic and diastolic blood pressure, were recorded. Moreover, the amount and degree of ecchymosis and edema were determined.

There was no significant difference between the two groups in terms of duration of surgery, bleeding during surgery, mean heart rate, ecchymosis, edema, and diastolic blood pressure at different times. Mean heart rate and diastolic blood pressure at different time were not significantly different between the two groups, too. But, the amount of reducing in systolic blood pressure at 5 minutes in remifentanil group (17.64 ± 14.39 mmHg) was significantly lower than nitroglycerin group (25.60 ± 7.09 mmHg).

The results indicate similar function of remifentanil and nitroglycerin in reducing intraoperative bleeding and complications during and after rhinoplasty surgery.