Comparison of Blood Loss during Functional Endoscopic Sinus Surgery with Propofol and Dexmedetomidine or Desflurane: A Randomized Controlled Trial

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Nichawan Wirachpisit

Abstract

Background: Poor visualization due to bleeding during endoscopic sinus surgery leads to bad outcomes. Anesthetic technique is one of the most important factors to reduce blood loss. However, no definite conclusion


whether which technique is the best. This study aimed to compare inhalation anesthesia technique (desflurane) with total intravenous anesthesia technique (dexmedetomidine and propofol) on blood loss and surgical field condition. Method: A prospective, randomized controlled study was conducted in 40 patients undergoing elective endoscopic sinus surgery. They were randomly assigned into 2 groups: desflurane group (N=20) and dexmedetomidine and propofol group (N=20). The target mean arterial pressure (MAP) was maintained at 65-75 mmHg. Visibility of surgical field is rated numerically (1-10). The primary outcomes were intraoperative blood loss and surgical field conditions. Secondary outcomes were pain scores at the recovery room and the day after surgery. Result: Forty patients were enrolled. One patient in dexmedetomidine and propofol group dropped out


due to asthmatic attack during the operation. Baseline characteristics were not different between two groups. Total blood loss was not different between two anesthetic techniques. Visualized surgical fields were similar. Dexmedetomidine combined with propofol group seemed to have low pain score but not different. Conclusion: This study cannot demonstrate the effect of propofol and dexmedetomidine based anesthesia on reduction of blood loss in endoscopic sinus surgery. The preoperative discussion of anesthesia technique preferences between the surgeon and the anesthesiologist may be necessary.

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References

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