Oral bisoprolol improves surgical field during functional endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Anesthesiology
• Pharmacology

Background:

• Functional endoscopic sinus surgery (FESS) requires clear visualization of the surgical field for success.
• Bleeding during FESS can compromise visual clarity and surgical outcomes.
• Bisoprolol, a beta-blocker, was investigated for its potential to mitigate bleeding during FESS.

Purpose of the Study:

• To evaluate the efficacy of a pre-operative 2.5 mg dose of bisoprolol in reducing intraoperative bleeding during FESS.
• To determine if bisoprolol improves the visualization of the surgical field during FESS.
• To compare the effects of bisoprolol versus placebo on bleeding and visualization in FESS patients.

Main Methods:

• A double-blind, randomized, controlled study involving 30 American Society of Anesthesiologists I or II patients undergoing FESS.
• Patients received either a placebo or 2.5 mg of bisoprolol 90 minutes prior to surgery.
• Anesthesia was maintained to target a mean arterial pressure (MAP) of 60-70 mmHg, with blood loss and surgical field grading (Fromme-Boezaart Scale) assessed.

Main Results:

• Significantly less blood loss in the bisoprolol group (110.67 ± 45.35 ml) compared to the placebo group (398.67 ± 228.79 ml) (P < 0.0001).
• Superior surgical field grading was observed in patients who received bisoprolol (P = 0.0001).
• Lower isoflurane and fentanyl requirements, along with lower MAP and heart rate, were noted in the bisoprolol group.

Conclusions:

• Pre-operative administration of 2.5 mg bisoprolol significantly reduces blood loss during FESS.
• Bisoprolol improves the visualization of the operative field in FESS.
• This study supports the use of bisoprolol as an effective adjunct for optimizing FESS procedures.