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Hypotensive anaesthesia and bleeding during endoscopic sinus surgery: an observational study.
A Cardesín1, C Pontes, R Rosell
1Rhinology Unit, Department of Otorhinolaryngology, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí nº 1, 08028, Sabadell, Spain, acardesin@tauli.cat.
Summary
Clonidine-based anesthesia significantly reduces intraoperative bleeding during functional endoscopic naso-sinusal surgery (FESS). This cost-effective approach improves surgical conditions and patient outcomes by minimizing blood loss in the surgical field.
Area of Science:
- Otolaryngology
- Anesthesiology
- Surgical Innovation
Background:
- Intraoperative bleeding during functional endoscopic naso-sinusal surgery (FESS) complicates anatomical landmark identification and can compromise surgical results.
- Adjuvant anesthetic agents, through their hypotensive effects, can influence intraoperative bleeding levels.
Purpose of the Study:
- To compare intraoperative bleeding in patients undergoing FESS with a clonidine-based anesthetic regimen versus other anesthetic combinations.
- To evaluate the efficacy and cost-effectiveness of clonidine for controlled hypotensive anesthesia during FESS.
Main Methods:
- A prospective observational study involving 37 patients undergoing FESS.
- Assessment of intraoperative bleeding using Boezaart scores, comparing clonidine-based anesthesia (N=11) with opioid derivative-based anesthesia (N=26).
Main Results:
- Patients receiving clonidine exhibited significantly lower surgical field bleeding scores (1.91 ± 0.53) compared to those on opioid derivatives (2.92 ± 0.79) (p < 0.0001).
- Multivariate analysis identified anesthetic drug type as the best predictor of bleeding intensity, with clonidine-based anesthesia showing an odds ratio of 0.03 (p = 0.014).
Conclusions:
- Clonidine-based anesthesia leads to reduced surgical field bleeding during FESS.
- Clonidine is an inexpensive anesthetic agent that improves surgical conditions, potentially reducing surgical time, patient morbidity, and enhancing operating room efficiency.
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