Comparison of surgical conditions during propofol or desflurane anesthesia for endoscopic sinus surgery

Cho, K.; Lee, K.; Kim, M.; Cheong, Soon Ho; Shin, Chee Mahn; Lee, J.

doi:10.1097/00003643-201206001-00083

Cited by 5 publications

(8 citation statements)

References 2 publications

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“…One study was excluded because it did not control for the short acting opioid used in the TIVA and IA groups. Thus 12 studies satisfied the inclusion and exclusion criteria and were included in the meta-analysis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) . No additional studies were identified by checking the references of relevant papers.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have specifically evaluated the use of propofol and a short acting opioid versus a volatile inhalational anaesthetic and a short acting opioid. Some randomized controlled trials (RCTs) on the topic have shown that TIVA is superior to IA with regards to the quality of the surgical field (1)(2)(3)(4) . Studies have also suggested that blood loss is lower with TIVA compared to IA (1,3,5) .…”

Section: Introductionmentioning

confidence: 99%

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Total intravenous anaesthesia versus inhaled anaesthesia for endoscopic sinus surgery: a meta-analysis of randomized controlled trials

Kolia

Man

2019

Rhin

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Background: Total intravenous anaesthesia (TIVA) with propofol, compared to inhaled anaesthesia (IA), has been proposed to reduce bleeding and improve surgical field quality during endoscopic sinus surgery (ESS), but prior meta-analyses have not been conclusive. We performed an updated meta-analysis to determine the benefit of TIVA versus IA during ESS.Methodology: PubMed, EMBASE, and Cochrane Library were searched for randomized controlled trials (RCTs) comparing TIVA versus IA. Demographic and outcome data were extracted from articles meeting selection criteria and analysed.Results: We included 12 RCTs for a total of 560 patients. Preoperative characteristics were similar between the two groups. Compared to IA, TIVA improved surgical visibility, estimated blood loss (EBL), and operative time. In a subgroup analysis with remifentanil as the short-acting opioid, TIVA improved surgical visibility, EBL, and operative time. These benefits were not seen with fentanyl as the short-acting opioid.Conclusions: TIVA with propofol, in comparison to IA, may improve surgical field quality, reduce blood loss, and decrease operative time for ESS. Remifentanil is the preferred short-acting opioid for TIVA in ESS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Total intravenous anaesthesia versus inhaled anaesthesia for endoscopic sinus surgery: a meta-analysis of randomized controlled trials

Kolia

Man

2019

Rhin

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“…Chok et al 12 compared surgical field condition between propofol/remifentanil (PR) based anesthesia and desflurane/remifentanil (DR) based anesthesia in endoscopic surgery. They discovered that anaesthesia based on propofol/remifentanil(PR) provided a superior surgical field for endoscopic sinus surgery than anaesthesia based on desflurane/remifentanil.…”

Section: Discussionmentioning

confidence: 99%

A randomised comparative study of desflurane and sevoflurane with esmolol to evaluate hemodynamic parameters and recovery characteristics in middle ear surgery

Arivazhagan¹,

Engineer

2022

IJCA

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To produce a blood less field for middle ear surgery performed with operating microscope, controlled hypotention is essential which achieve by means of Inhalational agents and Esmolol.The goal of the study was to assess the effects of Desflurane and Sevoflurane vs esmolol in terms of creating controlled hypotension, intraoperative blood loss, surgeon satisfaction with the surgical field, and complications. From December 2019 to July 2021, a prospective, randomised, double-blind trial was undertaken. A total of 100 patients, ranging in age from 18 to 60 years, were recruited and had elective middle ear procedures in the Department of Oto-rhino-laryngology operating theatre. Simple randomization (computer-generated) was used to divide the patients into two groups: Group S and Group D. Inj. Esmolol 0.5 mg/kg was administered as a loading dose, followed by a continuous infusion, and Propofol 2 mg/kg was used to produce anaesthesia. Inj. Vecuronium (0.1mg/kg) was administered to help with laryngoscopy and intubation. Oxygen, Nitrous oxide, Sevoflurane 1-3 percent (Group S) or Desflurane 3-6 percent (Group D) and intermittent InjVecuronium (0.05 mg/kg) were used to maintain anaesthesia. Intraoperative haemodynamics, six-point bleeding score, surgeon satisfaction, and postoperative Aldrete recovery score were all observed. Microsoft Excel was used to input and evaluate the data.When comparing Group S to Group D, haemodynamic measures were significantly different (p value 0.05). When comparing Group S to Group D, the six-point bleeding score and surgeon satisfaction score were considerably higher in Group S (p value 0.05). Within 5 minutes of surgery, 100% of patients in Group D and 76% of patients in Group S had achieved an aldrete score of 9,10.In middle ear surgery, sevoflurane produces more controlled hypotension. When compared to the Desflurane group, the sevoflurane group had superior surgical field vision and a higher surgeon satisfaction score. When compared to the Sevoflurane group, the Desflurane group had a superior post-operative Aldrete recovery score.

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“…The primary statistical endpoint was the NRS for surgical condition. Based on previous studies (21,22) , we calculated that 60 patients were required to give the study a statistical power of 80% at a 5% level of significance. Considering the probability of sample size loss, 10% more patients were enrolled.…”

Section: Discussionmentioning

confidence: 99%

Intranasal atomised dexmedetomidine optimises surgical field visualisation with decreased blood loss during endoscopic sinus surgery: a randomized study

Qiao¹,

Chen²,

Li³

et al. 2016

Rhin

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Comparison of surgical conditions during propofol or desflurane anesthesia for endoscopic sinus surgery

Cited by 5 publications

References 2 publications

Total intravenous anaesthesia versus inhaled anaesthesia for endoscopic sinus surgery: a meta-analysis of randomized controlled trials

Total intravenous anaesthesia versus inhaled anaesthesia for endoscopic sinus surgery: a meta-analysis of randomized controlled trials

A randomised comparative study of desflurane and sevoflurane with esmolol to evaluate hemodynamic parameters and recovery characteristics in middle ear surgery

Intranasal atomised dexmedetomidine optimises surgical field visualisation with decreased blood loss during endoscopic sinus surgery: a randomized study

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