Comparison of Desflurane, Sevoflurane, and Total Intravenous Anesthesia in Ear Surgery Under Controlled Hypotension

Controlled hypotension is commonly used in ear surgery to reduce intraoperative bleeding and improve the surgical field. However, the effects of different anesthetic maintenance techniques used during controlled hypotension on postoperative cognitive function remain unclear.

This prospective randomized study included adult patients undergoing elective ear surgery. Patients were randomly assigned to receive desflurane, sevoflurane, or total intravenous anesthesia for maintenance of anesthesia under controlled hypotension.

The primary objective of the study was to evaluate postoperative cognitive dysfunction. Secondary objectives included comparison of intraoperative hemodynamic stability, cerebral oxygenation, and perioperative clinical outcomes among the three anesthesia techniques.

Hemodynamic parameters and cerebral oxygen saturation were recorded at predefined time points during the intraoperative period. Postoperative cognitive function was assessed using standardized cognitive evaluation methods.

The findings of this study aim to contribute to the selection of optimal anesthetic techniques in ear surgery performed under controlled hypotension.

Inclusion criteria

• Patients aged 18 years and older
• ASA physical status I-II
• Scheduled for elective tympanoplasty, mastoidectomy, or tympanomastoidectomy under general anesthesia
• Provided written informed consent

Exclusion criteria

• Patients with known neurological or psychiatric disorders affecting cognitive function
• Pre-existing cognitive impairment
• Severe hepatic or renal insufficiency
• History of alcohol or substance abuse
• Inability to complete cognitive function tests
• Emergency surgery
• Refusal to participate in the study