TY - JOUR
T1 - Pilot study comparing total intravenous anesthesia to inhalational anesthesia in endoscopic sinus surgery
T2 - Novel approach of blood flow quantification
AU - Gomez-Rivera, Fernando
AU - Cattano, Davide
AU - Ramaswamy, Uma
AU - Patel, Chirag B.
AU - Altamirano, Alfonso
AU - Man, Li Xing
AU - Luong, Amber
AU - Chen, Zhongxue
AU - Citardi, Martin J.
AU - Fakhri, Samer
N1 - Funding Information:
From the Department of Otorhinolaryngology-Head and Neck Surgery (Gomez-Rivera, Ramaswamy, Patel, Luong, Citardi, Fakhri), the Department of Anesthesiology (Cattano, Altamirano), and the Center for Clinical and Translational Science (Chen), University of Texas Medical School at Houston, Houston, Texas, and the Department of Otolaryngology, University of Rochester, Rochester, New York (Man). Dr Cattano is a paid consultant for Smiths Medical (Dublin, Ohio) and receives grant support from Covidien (Dublin, Republic of Ireland), Karl Storz (Tuttlingen, Germany), and Haemonetics (Braintree, Massachusetts). Dr Fakhri is a paid consultant for ArthroCare ENT (Austin, Texas) and Terumo Medical (Tokyo, Japan).
PY - 2012/11
Y1 - 2012/11
N2 - 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.
AB - 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.
KW - Chronic rhinosinusitis
KW - Endoscopic sinus surgery
KW - Optical rhinometry
KW - Total intravenous anesthesia
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U2 - 10.1177/000348941212101105
DO - 10.1177/000348941212101105
M3 - Article
C2 - 23193905
AN - SCOPUS:84870178736
SN - 0003-4894
VL - 121
SP - 725
EP - 732
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
IS - 11
ER -