Abstract
BackgroundBleeding during functional endoscopic sinus surgery is a challenge for the quality of the surgical field for surgeons. This study aimed to evaluate the effect of desmopressin premedication on blood loss and the quality of the surgical field in endoscopic sinus surgery.MethodsA total of 90 American Society of Anesthesiologists physical status I–II patients underwent endoscopic sinus surgery for chronic sinusitis. They were randomly allocated to receive either desmopressin 0.3 μg/kg or saline before the operation. Management of anesthesia was achieved with propofol and remifentanil infusions, with moderate, controlled hypotension. Blood loss and quality of the surgical field were assessed after surgery. Effects of desmopressin on anesthetic requirements and hemodynamic variables were analyzed.ResultsBlood loss was significantly less in the desmopressin group (mean ± SD, 42 ± 8.7 ml) than in the control group (70 ± 9.2 ml, P < 0.001). Surgeons were more satisfied with the surgical field in the desmopressin group than in the control group (median score, 4 [3–5] vs. 7 [6–9], P < 0.001). Requirements for remifentanil and esmolol were lower in the desmopressin group than in the control group.ConclusionsPremedication with desmopressin 0.3 μg/kg can effectively reduce bleeding during endoscopic sinus surgery.
Highlights
Bleeding during functional endoscopic sinus surgery is a challenge for the quality of the surgical field for surgeons
This study aimed to determine the effect of administration of desmopressin on intraoperative blood loss and the surgical field in patients undergoing endoscopic sinus surgery
There was a significant effect of desmopressin on blood loss and quality of the surgical field (Table 2)
Summary
Bleeding during functional endoscopic sinus surgery is a challenge for the quality of the surgical field for surgeons. This study aimed to evaluate the effect of desmopressin premedication on blood loss and the quality of the surgical field in endoscopic sinus surgery. Major blood loss during FESS is rare, even a small amount of blood may disturb the surgical view. This disturbance prolongs the operation time, increases the likelihood of complications, and possibly results in incomplete surgery [2]. Several techniques have been suggested to improve the surgical field in endoscopic sinus surgery, such as bipolar diathermy, topical vasoconstrictors, local injection of epinephrine, Desmopressin (1-deamino-8-D-arginine vasopressin) has been used as a treatment for mild to moderate hemophilia and von Willebrand’s disease.
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