The use of appropriate anaesthetic agents is essential to avoid complications during middle ear surgery. This Turkish study attempted to identify whether intravenous (IV) anaesthetics (propofol) or inhalational agents (sevoflurane) cause more variations in middle ear pressures. The authors performed a prospective study of 57 ASA I-II patients between the ages of 18-65 years, who were not undergoing otological operations. The patients were randomly allocated to either the propofol (P) group or sevoflurane (S) group according to the anaesthetic agent that they received intraoperatively. Baseline tympanometry was recorded before anaesthesia was introduced, and then repeated at 5, 10, 15 and 30 minutes post induction of anaesthetic agent. All post-induction middle ear pressures (MEP) were higher in the S group than baseline, whilst there was no difference between the post-induction MEP values and baseline in the P group. All post-induction MEP values were significantly higher in the S group than the P group (p < 0.05). These results reinforce previous studies that suggest that IV anaesthetic agents (such as propofol) are more reliable than inhalational agents (such as sevoflurane) in middle ear surgery.

Middle ear pressure changes with sevoflurane and propofol-remifentanil.
Dogan M, Duger C, Uysal IO, et al.
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Sunil Sharma

Alder Hey Children's Hospital, UK.

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