Pilot Study Comparing Total Intravenous Anesthesia to Inhalational Anesthesia in Endoscopic Sinus Surgery: Novel Approach of Blood Flow Quantification
| Autor: | Fernando Gomez-Rivera, Alfonso Altamirano, Samer Fakhri, Amber U Luong, Davide Cattano, Li-Xing Man, Uma Ramaswamy, Chirag B. Patel, Zhongxue Chen, Martin J. Citardi |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Methyl Ethers medicine.medical_specialty Blood Loss Surgical Remifentanil Pilot Projects Sevoflurane law.invention Double-Blind Method Piperidines Randomized controlled trial law Paranasal Sinuses medicine Humans Prospective Studies Sinusitis Prospective cohort study Propofol Aged Rhinitis medicine.diagnostic_test Inhalation Total intravenous anesthesia business.industry Endoscopy General Medicine Blood flow Middle Aged Surgery Otorhinolaryngology Anesthesia Anesthetics Inhalation Anesthesia Intravenous Female Anesthesia Inhalation business Anesthetics Intravenous medicine.drug |
| Zdroj: | Annals of Otology, Rhinology & Laryngology. 121:725-732 |
| ISSN: | 1943-572X 0003-4894 |
| DOI: | 10.1177/000348941212101105 |
| Popis: | Objectives: We compared anesthesia with sevoflurane–remifentanil hydrochloride (SR) to total intravenous anesthesia with propofol–remifentanil hydrochloride (PR) in patients undergoing endoscopic sinus surgery for chronic rhinosinusitis in terms of sinonasal mucosal blood flow, the surgical field visualization score, and blood loss. Methods: We performed a double-blinded prospective study at a tertiary care center in 23 adults scheduled to undergo endoscopic sinus surgery for chronic rhinosinusitis. The patients were randomized to receive SR or PR. The sinonasal mucosal blood flow was measured by optical rhinometry. The surgical field visualization score was based on the Boezaart scale. Results: The groups had similar clinical characteristics. During the 60- to 90-minute and 90- to 120-minute operative time windows, the blood flow was significantly greater in the PR group than in the SR group (p = 0.04 and p = 0.03, respectively). The amounts of blood loss in the PR and SR groups were 152.9 ± 161.3 mL and 355.9 ± 393.4 mL, respectively (p = 0.12). The median ratios of the surgical field visualization score to the number of sinuses operated on in the PR and SR groups were 2.1 and 1.8, respectively (p = 0.52). Conclusions: The intraoperative blood flow, as determined by optical rhinometry, was significantly greater with anesthesia with PR than with anesthesia with SR, 1 hour into the procedure; however, this difference did not translate into differences in the amounts of operative blood loss or in the surgical field visualization scores. |
| Databáze: | OpenAIRE |
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