General Anesthesia With or Without Local Ear Block in Middle Ear Surgeries

ear block by 0.25% bupivacaine

ear block by Normal Saline Flush, 0.9% Injectable Solution

general anesthetic by midazolam 0.02 mg kg-1 , propofol 2-3 mg kg-1 and lidocaine 0.5 mg kg-1 , fentanyl 2 μg kg-1 , atracurium 0.5 mg kg-1 , isoflurane in 50% oxygen/air.

hypotensives for deliberate hypotension by nitroglycerine 0.5-10 μg /kg/min and increments of 0.2 mg propranolol