nitroglycerine + propranolol

This pharmacological intervention consists of a combination of the vasodilator nitroglycerine and the non-selective beta-blocker propranolol, specifically utilized to induce deliberate or controlled hypotension during middle ear surgeries, such as those for tympanic membrane perforation. Nitroglycerine acts as a nitric oxide donor, stimulating soluble guanylate cyclase to produce vasodilation and lower blood pressure. Propranolol is administered in increments to manage heart rate and assist in blood pressure control, preventing reflex tachycardia that can occur with vasodilation. The primary objective of this regimen is to minimize intraoperative blood loss and provide a bloodless surgical field, which is essential for the precision required in microsurgical procedures of the ear.

Other names

deliberate hypotension agentshypotensives