Comparison of different methods of general anaesthesia for controlled hypotension in functional endoscopic sinus surgery (FESS)

Abstract

Introduction and Aims: Functional Endoscopic Sinus Surgery (FESS) is minimal invasive technique for management of chronic sinusitis. Controlled hypotension is required in FESS for bloodless field, better visualization, reduce operative time and bleeding. Various agents like ? blockers, ?+? blockers, magnesium sulfate etc. used to achieve controlled hypotension. The aim of study was to produce controlled hypotension with propofol and isoflurane and to compare intraoperative blood loss, duration of surgery, operative field condition. Materials and Methods: Sixty patients were assigned in either group by computer generated random number table. Patients in Group A received propofol infusion and in group B received isoflurane in concentration to achieve MBP between 60 to 70 mmHg. Bispectral index value was also maintained between 40 to 60. Statistical difference between two groups was determined using unpaired student t test except for surgical field condition, for which Median test for two populations was used. A “p” value Result: There was no statistically significant difference in MBP between both groups. Mean intra-operative blood loss was less in group A (115.17±12.07 ml) compared to group B (140.5±15.83 ml). Mean duration of surgery was shorter in group A (109±9.32 min) compared to group B (131.67±12.82 min). Operative field condition was better in Group A compared to Group B (p=0.0026). Conclusion: Both propofol and isoflurane effective in producing controlled hypotension, but anaesthesia with propofol is associated with less blood loss, shorter duration of surgery and better surgical field condition compared to isoflurane. Keywords: Bispectral Index, Controlled hypotension, Functional endoscopic sinus surgery, Isoflurane, Propofol.