ABSTRACT
BACKGROUND AND OBJECTIVES: Functional endoscopic sinus surgery (FESS) being a delicate technique, intraoperative bleeding is one of the major challenges. Even a little bleeding can adversely affect the surgeon's ability to visualize the region to be operated. General anesthesia is preferred over topical anesthesia in FESS. This study was conducted to compare the surgical field using total intravenous anesthesia (TIVA) with propofol and inhalational anesthesia with isoflurane for FESS. Secondary outcomes such as intraoperative blood loss and the incidence of perioperative complications were also recorded. SUBJECTS AND METHODS: A total of sixty patients in the age group of 16-60 years with physical status American Society of Anesthesiologists Classes I and II, undergoing FESS were randomly divided into two groups of thirty each after taking informed consent and approval from the Hospital Ethics Committee. Thirty patients in Group I: received isoflurane-based inhalational anesthesia and other Thirty patients in Group II: were administered TIVA with propofol. Various parameters were recorded and statistically analyzed. RESULTS: There was improved quality of surgical field at the end of surgery in the Group II as compared to Group I. Total blood loss during surgery and incidence of intraoperative complications were less in Group II as compared to Group I. CONCLUSION: This study concludes that in FESS, using TIVA with propofol decreases blood loss and the incidence of complications during surgery in addition to providing good quality of surgical field.
ABSTRACT
BACKGROUND: Post operative analgesia in patients undergoing lower limb surgery is very essential for immediate postoperative pain relief which can be provided by oral or parentral medication, epidural analgesia, local blocks etc.The study was designed to evaluate the efficacy of epidural butorphanol and tramadol for postoperative pain relief. PATIENTS #ENTITYSTARTX00026; METHODS: This was randomized, prospective, double blind study was conducted on 60 patients, ASA grade I&II, age 18-60 undergoing lower limb surgeries after approval from hospital ethics committee. Group allocation - Group I I (n=30) received 2 mg butorphanol as bolus epidurally, 1 mg for top up dose. Group II (n=30) received 100mg tramadol as bolus, 50 mg for top up. All the drugs were diluted to 10 ml normal saline & the observer was blinded to the drugs given. Postoperatively VAS, sedation score, vitals & side effects were observed. Top ups were given on achieving VAS>4. Diclofenac 75mg was given as rescue analgesia. RESULTS: Duration of analgesia was 5.35±0.29 hr and 6.25±1.58 hrs in Butorphanol and Tramadol groups respectively and the difference was found to be statistically significant. Pain scores were also significantly lower statistically in Group I as compared to Group II. Sedation scores were significantly higher in butorphanol group, whereas nausea vomiting was seen in tramadol group only (4 patients).No other side effects were observed. CONCLUSIONS: Both butorphanol and tramadol were effective for relieving postoperative pain, however quality of analgesia & patient satisfaction was more with butorphanol.
ABSTRACT
A study conducted on seventy-five cases of chronic maxillary sinusitis presenting at the E.N.T. Outpatients' Department of Dayanand Medical College, Ludhiana revealed the presence of fungi in 8 cases. The return fluids of proof puncture and antral lavage of the sinuses were subjected to standard extraction procedures. Methods of isolation and identification of the causal fungi are described. The role of fungi, particularly Aspergillus, as pathogen is discussed in the context of antibiotic and immuno-suppressive therapy and local predisposing factors.
