The effects comparison of controlled hypotension induced by in neurosurgery sodium nitroprusside and remifentanil

Objective:To compare effects of remifentanil and sodium nitroprusside(SNP) for controlled hypotension during neurosurgical operation.Methods:60 patients with craniotomy were randomly devided into group R(30 cases) and group S(30 cases).Anesthesia induction and maintenance in both groups were using the same method.Group R were infused with remifentanil 0.1～0.5μg/kg·min and group S were infused with SNP 0.5～3μg/kg·min for controlled hypotension.The target of controlled hypotension was fixed at MAP 60～65mmHg,which was maintained for 60 minutes.The hemodynamic changes in two groupswere recorded during surgery and amount of blood loss,extubation time were also compared.Results:The patients in both groups could maintain MAP at 60～65mmHg during controlled hypotension.There wasn't significant difference during controlled hypotension between two groups(P0.05).HR was significantly reduced in R group compared with pre-controlled hypotension(P0.05) and was significantly increased in S group during controlled hypotension(P0.05).The amount of blood loss and extubation time weren't significant difference between two groups.Conclusion:Remifentanil is a safe and effective drug for controlled hypotension in neurosurgical operation and its clinical efficacy is better than that of sodium nitroprusside.