Anesthetic Effects on Surgical Blood Loss

Bunker, John P.

doi:10.1111/j.1749-6632.1964.tb41073.x

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Because nasal bleeding during endoscopic sinus surgery can cause difficulties in maintaining and managing the airway, general anesthesia is preferred for most patients undergoing nasal surgeries . However, it has been assumed that general anesthesia could cause increased intraoperative bleeding during surgery by lowering capillary resistance . Impairment of intraoperative visibility due to bleeding is also a problem in endoscopic sinus surgery.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review

Kim

Kang

et al. 2018

The Laryngoscope

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Objectives Tranexamic acid might help control bleeding during surgery because of antifibrinolytic characteristics. We aimed to evaluate the effectiveness of systemic tranexamic acid compared to control in blood loss, operative time, and surgical field and incidence of postoperative emesis and thromboembolism in endoscopic sinus surgery. Methods Two authors independently searched six databases (PubMed, SCOPUS, Embase, the Web of Science, Google Scholar, and the Cochrane database) from their inception to July 2018. The included studies compared perioperative tranexamic acid administration (treatment group) with a placebo, and the outcomes of interest were intraoperative morbidities, including surgical time, operative bleeding, and hypotension; postoperative morbidities such as nausea and vomiting; and coagulation profiles. Results Seven studies comprising 562 participants were reviewed in this study. Operative time (standardized mean difference (SMD) = −0.60; 95% confidence interval (CI)[−0.93, −0.29]) and intraoperative blood loss (SMD = −0.66; 95% CI [−0.86, −0.46]) were statistically lower in the treatment group than placebo group; and the quality of the surgical field (SMD = −0.80; 95% CI [−1.12; −0.48]) and surgeon satisfaction (SMD = 1.74; 95% CI [1.36; 2.13]) were statistically higher in the treatment group than the placebo group. By contrast, there were no significant differences in the hemodynamic (SMD = 0.08; 95% CI [−0.20; 0.37]) and coagulation profiles (SMD = −0.18; 95% CI [−0.42, 0.07]) of the two groups. Additionally, tranexamic acid had no significant effect on emetic or thrombotic events compared to placebo. Conclusion This meta‐analysis showed that the systemic administration of tranexamic acid could decrease operative time and blood loss intraoperatively, increasing the satisfaction of surgeons. It did not provoke intraoperative hemodynamic instability, postoperative emetic events, or coagulation profile abnormality. Only a small number of studies were enrolled, so further trials are needed to confirm the results of this study. Laryngoscope, 129:800–807, 2019

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Section: Introductionmentioning

confidence: 99%

Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review

Kim

Kang

et al. 2018

The Laryngoscope

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Does topical application of tranexamic acid reduce intraoperative bleeding in sinus surgery during general anesthesia?

Kang

Hwang

2020

Brazilian Journal of Otorhinolaryngology

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Can Dexmedetomidine Influence Recovery Profiles from General Anesthesia in Nasal Surgery?

Lee

Yoon

Jin

et al. 2017

Otolaryngol.--head neck surg.

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Objectives Dexmedetomidine has sympatholytic, sedative, anesthetic, and analgesic effects, as well as vasoconstrictive effects, which may help prevent hypotension under general anesthesia. This meta-analysis aimed to perform a systematic review of the literature and investigate the effect of dexmedetomidine on perioperative morbidity following nasal surgery and its adverse effects. Data Sources MEDLINE, SCOPUS, and the Cochrane database. Review Methods Two authors independently searched the databases from their inception to March 2017. Studies were selected that compared perioperative dexmedetomidine administration (dexmedetomidine groups) with a placebo or remifentanil (control groups) with regard to intraoperative morbidity, including surgical time, bleeding amount, hypotension, and bradycardia during operation, and postoperative morbidity, such as emergence agitation, nausea and vomiting, and sedation after operation. Results Surgical time, intraoperative blood loss, dose of inhaled anesthetic gas, dose of fentanyl, postoperative pain, and incidence of emergence agitation were significantly lower in the dexmedetomidine group versus the placebo group. In contrast, there were no significant differences in intraoperative hemodynamic stability and postoperative residual sedation and nausea and vomiting between groups. Additionally, compared with remifentanil (a currently widely used agent), dexmedetomidine was superior in view of postoperative pain and intraoperative blood pressure control. Conclusion This meta-analysis shows that the systemic administration of dexmedetomidine can decrease surgical time, intraoperative blood loss, and doses of intraoperative inhaled anesthetic gas and fentanyl as compared with placebo. It can also decrease postoperative pain and incidence of the emergence agitation. Due to the small number of studies, further clinical trials are needed to confirm these results.

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Anesthetic Effects on Surgical Blood Loss

Cited by 3 publications

References 11 publications

Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review

Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review

Does topical application of tranexamic acid reduce intraoperative bleeding in sinus surgery during general anesthesia?

Can Dexmedetomidine Influence Recovery Profiles from General Anesthesia in Nasal Surgery?

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