Magnesium sulfate or diltiazem as adjuvants to total intravenous anesthesia to reduce blood loss in functional endoscopic sinus surgery.
OBJECTIVE
This study was designed to know whether addition of magnesium sulfate (MgSO4) or diltiazem to total intravenous anesthesia (TIVA) (propofol) aided reduction in blood loss during functional endoscopic sinus surgery (FESS). The secondary outcomes measured were surgeon's assessment of the surgical field and hemodynamics.


METHODS
Randomized, double-blinded, placebo-controlled trial.


METHODS
Operating room.


METHODS
Forty-five American Society of Anesthesiologists I and II adult patients (18-60years) undergoing FESS.


METHODS
All groups received propofol-fentanyl TIVA. Patients were randomly allocated to 1 of the 3 groups (MgSO4 group, n=15; diltiazem group, n=15; saline group, n=15).


METHODS
Intraoperative bleeding was quantified, and quality of surgical field was graded. Hemodynamic parameters were recorded.


RESULTS
Addition of both MgSO4 and diltiazem significantly reduced blood loss (240 and 350mL) in comparison to control group (415mL) (P=.003). The surgical field was significantly better in the MgSO4 group compared with the diltiazem (P=.028) and saline groups (P=.0001).


CONCLUSIONS
It was concluded that the addition of both MgSO4 and diltiazem to TIVA propofol results in significant reduction in blood loss and significant improvement in the quality of surgical field during FESS without causing any adverse effects on the hemodynamics or on the recovery from anesthesia. The surgical field in the MgSO4 group was significantly better than that in the diltiazem group (P=.04).
AIIMS, New Delhi, India. Electronic address: ajishaa@gmail.com.
Ajisha
A
Aravindan
AIIMS, New Delhi, India. Electronic address: drsrajeshwari@gmail.com.
Rajeshwari
R
Subramanium
AIIMS, New Delhi, India. Electronic address: anjolie5@hotmail.com.
Anjolie
A
Chhabra
AIIMS, New Delhi, India. Electronic address: priyankar.k.datta@gmail.com.
Priyankar K
PK
Datta
AIIMS, New Delhi, India. Electronic address: vimirewari@gmail.com.
Vimi
V
Rewari
AIIMS, New Delhi, India. Electronic address: Suresh6sharma@yahoo.com.
Suresh C
SC
Sharma
AIIMS, New Delhi, India. Electronic address: Winyrk@hotmail.com.
Rakesh
R
Kumar
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004110:Diltiazem / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D015742:Propofol / Q000008:administration & dosage; D012852:Sinusitis / Q000601:surgery*; D055815:Young Adult
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D008278:Magnesium Sulfate; D004110:Diltiazem; D015742:Propofol
Bleeding; Diltiazem; FESS; Field; MgSO(4); TIVA