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Propofol versus isoflurane for endoscopic sinus surgery.

J D Pavlin1, P S Colley, E A Weymuller

  • 1Department of Anesthesiology, University of Washington School of Medicine, Seattle 98105, USA.

American Journal of Otolaryngology
|April 15, 1999
PubMed
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Propofol anesthesia improved surgical conditions during endoscopic sinus surgery compared to isoflurane, with no significant difference in overall blood loss. Propofol offered advantages, especially in ethmoid and sphenoid sinus procedures.

Area of Science:

  • Anesthesiology
  • Otolaryngology
  • Surgical Outcomes

Background:

  • Previous retrospective studies suggested propofol anesthesia reduces bleeding during endoscopic sinus surgery (ESS).
  • A prospective comparison was needed to validate these findings and assess surgeon-reported operating conditions.

Purpose of the Study:

  • To prospectively compare the effects of propofol versus isoflurane on measured blood loss during ESS.
  • To evaluate the surgeon's subjective assessment of operating conditions under both anesthetic agents.

Main Methods:

  • 56 patients undergoing ESS were randomized to receive either propofol or isoflurane anesthesia.
  • Blood loss was quantified by hemoglobin in suction canisters; surgeon bleeding assessment used a 4-point scale.
  • Statistical analyses included chi-squared, unpaired t-test, Mann-Whitney U, and permutation tests.

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Main Results:

  • Mean bleeding scores over time were significantly lower with propofol (P = .02), particularly in ethmoid and sphenoid sinus surgeries (P = .03).
  • A lower proportion of patients in the propofol group experienced scores >2 (30% vs. 54%; P = .033).
  • Time to discharge was shorter in the propofol group (183 vs. 243 minutes; P = .019).

Conclusions:

  • While overall surgical blood loss was similar between propofol and isoflurane, propofol demonstrated a subjective advantage in improving operating conditions.
  • This advantage was most notable in surgeries involving the ethmoid and sphenoid sinuses.