High-Sensitivity Cardiac Troponin Levels Difference in Before and After Ear and Nose Surgery with Controlled Hypotension Technique

Abstract

Background: Anesthesia with controlled hypotension or intraoperative hypotension (IOH) is a technique in which arterial blood pressure is lowered in a deliberate and predictable situation, aimed at facilitating surgery and reducing bleeding and transfusion requirements. However, this surgical technique is not without complications. Detection of MI depends on biomarker fluctuations. Cardiac troponin is the biomarker of choice for diagnosing myocardial damage and MI. Research on the relationship between hs-cTn levels and the incidence of postoperative myocardial infarction and controlled hypotension has never been done before, especially in troponin I and in ear and nose surgery. Methods: This study is an observational analytical study with a cross-sectional method to assess the incidence of myocardial infarction in patients undergoing elective tympanoplasty, mastoidectomy, septoplasty, rhinoplasty, and functional endoscopic sinus surgery (FESS). Results: There were 38 study subjects with 57.6% (20 subjects) being male and 47.4% (18 subjects) being female. The mean preoperative hs-cTn level was 33.87 ± 11.78 pg/mL, while the postoperative hs-cTn level was 43.46 ± 12.21. The mean change in hs-cTn levels between preoperative and postoperative was +9.59 ± 6.62 with a median of 7.78 (1.04-28.27) with a significant difference of p<0.001 and a high correlation (r=0.848). Conclusion: From our study, it can be concluded that the difference in hs-cTn levels between before and after ear and nose surgery with controlled hypotension technique is significantly different.