Comparison of surgical conditions during propofol or sevoflurane anaesthesia for endoscopic sinus surgery.
BACKGROUND
Endoscopic sinus surgery (ESS) is often affected by intra-nasal bleeding, which can be influenced by various anaesthetics and preoperative conditions. This study compared the surgical condition and the amount of intra-nasal bleeding between patients given sevoflurane/remifentanil (SR) and propofol/remifentanil (PR) anaesthesia.


METHODS
ASA I or II patients undergoing ESS were randomly assigned to group SR (n=20) or group PR (n=20). The extent of the preoperative surgical lesion was classified as high (> 12) and low Lund-Mackay (LM) (< or = 12) scores according to the computed tomography findings. The amount of intraoperative blood loss was calculated from the patients' haemoglobin (Hb) and the amount of blood in the suction canister. The surgeons rated the visibility of the surgical field on a numeric rating scale (NRS).


RESULTS
In the high-LM score patients, the median (1st/3rd quartiles) blood loss for the SR and PR groups was 135 (121/222) and 19 (8/71) ml h(-1), respectively (P<0.01), and the mean (SD) of NRS was 5.8 (2.3) and 2.3 (1.0), respectively (P<0.05). However, in patients with low-LM score, both blood loss and NRS scores were not different between groups SR and PR.


CONCLUSIONS
In the high-LM score patients, PR anaesthesia results in less blood loss and a better surgical conditions for ESS than SR anaesthesia.
Ahn
H J
HJ
Department of Anaesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine 135-710, 50 Ilwon-dong, Kangnam-ku, Seoul, Korea.
Chung
S-K
SK
Dhong
H-J
HJ
Kim
H Y
HY
Ahn
J H
JH
Lee
S M
SM
Hahm
T S
TS
Kim
J K
JK
D000328:Adult; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000601:surgery*; D010880:Piperidines; D015742:Propofol; D011446:Prospective Studies; D000077208:Remifentanil; D012720:Severity of Illness Index; D000077149:Sevoflurane; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol