title: Effects of three different types of anaesthesia on perioperative bleeding control in functional endoscopic sinus surgery.
abstract: The aim of the study was to assess the effect of three different types of anaesthesia on perioperative bleeding control and to analyse the mean arterial blood pressure and heart rate in patients undergoing endoscopic paranasal sinus surgery. Ninety patients (30 women and 60 men, aged 18-85 years) scheduled to undergo functional endoscopic sinus surgery in the years 2008-2010 were identified as candidates for inclusion in the study. Patients were randomly assigned to one of three groups (30 patients each) according to the type of general anaesthesia to be administered. Groups I and II both received inhalation anaesthesia (sevoflurane for sedation) and intravenous anaesthesia (fentanyl in group I, remifentanil in group II). Anaesthesia was delivered solely via intravenous route (TIVA) in group III, with propofol used for sedation and remifentanil for analgesia. Blood pressure and heart rate were monitored during surgery and post-surgically for 4 h. Mean anaesthesia duration in groups I, II and III was 108.7 ± 20.8, 112.6 ± 22.2 and 103.7 ± 17.5 min and the surgery duration was 71.3 ± 16.7, 78.8 ± 24.2 and 66.5 ± 15.5 min, respectively. Mean blood loss during surgery was 365.0 ± 176.2, 340.0 ± 150.5 and 225.0 ± 91.7 ml, with a mean blood loss rate of 5.1 ± 2.4, 4.5 ± 2.2 and 3.4 ± 1.1 ml/min in groups I, II and III, respectively. Technologically advanced control of the drug dose with the TIVA technique allows for better control of perioperative bleeding.
authors.affiliation: Department of Otolaryngology and Laryngological Oncology, 2nd Chair of Otolaryngology, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Miłoński
authors.forename: Hanna
authors.initials: H
authors.lastname: Zielińska-Bliźniewska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Golusiński
authors.forename: Joanna
authors.initials: J
authors.lastname: Urbaniak
authors.forename: Rafał
authors.initials: R
authors.lastname: Sobański
authors.forename: Jurek
authors.initials: J
authors.lastname: Olszewski
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001794:Blood Pressure / Q000187:drug effects; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000601:surgery*; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol