Comparative study between the effect of two different anesthetic methods on outcome of functional endoscopic sinus surgery

ABSTRACT

This Study compared intravenous anesthesia with traditional balanced anesthesia by subjective assessment of surgical conditions made by the surgeon with respect to the quality of surgical field, blood loss and recovery. 46 consecutive patients were randomly divided and assigned to receive either intravenous anesthesia [IVA] with propofol and remifentanil or with balanced anesthesia [BA] with alfentanil and sevoflurane during functional endoscopic sinus surgery [FESS]. Nitroglycerine infusion was used as hypotensive agent in both groups to keep mean arterial pressure [MAP] between 60 and 70 mm. Hg. The surgeons rated surgical conditions, bleeding from the surgical field and time of surgery for the cases with chronic sinusitis [maxillary and ethmoidal sinusitis]. Patients with massive polypi filling the nasal cavity were excluded from the study. Results of the present study showed that decrease in blood pressure was not different between the two groups, but heart rate was lower in the intravenous anesthesia group [62 beats per mm.] than in balanced anesthesia group [75 beats per min.]. Surgical conditions were rated to be significantly better [P Blood loss in IVA [130mL] was significantly less than BA [240mL]. Moreover the duration of surgery was significantly less in IVA group than BA group. It has been found also that the incidence of postoperative nausea vomiting was significantly less in IVA group. Using of propofol anesthesia during FESS was associated with decreased blood loss, ideal surgical field with less incidence of nausea and vomiting during recovery