title: Blood loss in endoscopic sinus surgery: assessment of variables.
abstract: OBJECTIVE
  To identify the variables that influence blood loss in endoscopic sinus surgery performed under uniform conditions of preoperative topical vasoconstriction and surgical technique.
  
  
  METHODS
  Blind, nonrandomized, observational study.
  
  
  METHODS
  One hundred thirty-eight consecutive patients who underwent endoscopic sinus surgery with the same technique in a university hospital over a 9-month period.
  
  
  METHODS
  Pearson product-moment correlation was used for numerical variables and nonparametric tests for categorical variables: Mann-Whitney (comparison of two independent variables) and Kruskal-Wallis (comparison of more than two independent variables).
  
  
  METHODS
  Operative time, total blood loss, and blood loss per minute were correlated with blood loss markers: age, sex, surgeon, type and severity of illness, septoplasty, and anesthetic agents used.
  
  
  RESULTS
  No correlation was found between age, sex, surgeon, and blood loss markers. Severe polyposis produced more blood loss than mild polyposis and sinusitis. Septoplasty showed an interesting inverse correlation with blood loss. Remifentanyl with fluorinated volatile agents was accompanied by less blood loss than other anesthetic agents.
  
  
  CONCLUSIONS
  More blood loss occurred with more severe sinonasal pathology. Blood loss may be reduced by using remifentanyl with a fluorinated volatile agent and, possibly, preoperative infiltration with epinephrine.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hospital Clinica Puerta de Hierro, Universidad Autonoma de Madrid, Madrid, Spain. dlagunaortega@yahoo.es
authors.forename: David
authors.initials: D
authors.lastname: Laguna
authors.forename: Cristobal
authors.initials: C
authors.lastname: Lopez-Cortijo
authors.forename: Isabel
authors.initials: I
authors.lastname: Millan
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Gonzalez
authors.forename: Jose R
authors.initials: JR
authors.lastname: Garcia-Berrocal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult