Blood loss in endoscopic sinus surgery: assessment of variables.
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.
Laguna
David
D
Department of Otolaryngology-Head and Neck Surgery, Hospital Clinica Puerta de Hierro, Universidad Autonoma de Madrid, Madrid, Spain. dlagunaortega@yahoo.es
Lopez-Cortijo
Cristobal
C
Millan
Isabel
I
Gonzalez
Francisco M
FM
Garcia-Berrocal
Jose R
JR
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