Role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery in Private Practice

Syed Ariful Islam,Md Arif Hossain Bhuyan,- Md Nurullah Md Nurullah,Md Shah Alam

doi:10.3329/bjo.v24i1.45328

Syed Ariful Islam, Md Arif Hossain Bhuyan + Show 2 more

Open Access

https://doi.org/10.3329/bjo.v24i1.45328

Copy DOI

Abstract

Background: Functional endoscopic sinus surgery (FESS), effective control of bleeding is essential to maintain a clear operative field and to minimize complications. Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objective: The objective of study was role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery and designed to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia. Methods: Prospective randomized study includes a total of 60 ASA I-II patients who underwent elective FESS surgery. Patients randomly assigned in two groups the hypotension group (Group A) and the normotension group (Group B). Intraoperative mean arterial pressure (MAP), heart rate (HR) were recorded. Results : This study shows the mean ages of the patients of group A group B were 33.36±7.61 and 32.46±7.73 years respectively. No statistically significant difference was observed among groups at 0.05 level in term of age. The mean heart rate pre-anaesthesia and preoperative among the patients of different groups in different follows up period. Significance differences were observed among groups in term of heart rate at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. The mean arterial mean blood pressure before pre-anaesthesia and preoperative estimation among the patients of different groups in different follows up period. Significance differences were observed among groups at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. Conclusion: This study demonstrated that Controlled hypotension can be achieved equally and effectively by nitroglycerin and labetalol reduced significantly intraoperative hemorrhage and produce hypotensive anesthesia. Both are equally effective in providing ideal surgical field during functional endoscopic sinus surgery (FESS). Bangladesh J Otorhinolaryngol; April 2018; 24(1): 8-13

Highlights

Anaesthesia influences intraoperative bleeding in several ways, both physiological & pharmacological - by changes in ventilatory pattern, positive end expiratory pressure (PEEP), posture & pharmacologically by induced alteration in myocardial contractility & peripheral vascular tone.[1]
Functional endoscopic sinus surgery (FESS) is a surgical procedure done with a fibreoptic camera inserted through nasal cavity, which is extremely well supplied with blood to moisten & warm inspired air.[2]
Controlled hypotension is defined as pharmacologically induced reduction in mean arterial blood pressure to 50-70 mm of Hg either by inducing changes in myocardial contractility or by peripheral vasodilatation[2,4,5]

Summary

Introduction

Anaesthesia influences intraoperative bleeding in several ways, both physiological & pharmacological - by changes in ventilatory pattern, positive end expiratory pressure (PEEP), posture & pharmacologically by induced alteration in myocardial contractility & peripheral vascular tone.[1]Functional endoscopic sinus surgery (FESS) is a surgical procedure done with a fibreoptic camera inserted through nasal cavity, which is extremely well supplied with blood to moisten & warm inspired air.[2]. Objective: The objective of study was role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery and designed to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia. The mean heart rate pre-anaesthesia and preoperative among the patients of different groups in different follows up period. The mean arterial mean blood pressure before pre-anaesthesia and preoperative estimation among the patients of different groups in different follows up period. Conclusion: This study demonstrated that Controlled hypotension can be achieved and effectively by nitroglycerin and labetalol reduced significantly intraoperative hemorrhage and produce hypotensive anesthesia. Both are effective in providing ideal surgical field during functional endoscopic sinus surgery (FESS)

Objectives

Methods

Findings

Conclusion