Surgical Field Visualization during Functional Endoscopic Sinus Surgery: Comparison of Propofol- vs Desflurane-Based...

Area of Science:

• Otolaryngology
• Anesthesiology
• Surgical Innovation

Background:

• Endoscopic sinus surgery (ESS) requires clear visualization, which can be impacted by bleeding.
• Anesthetic choice may influence bleeding and surgical field quality during ESS.

Purpose of the Study:

• To compare the effects of desflurane, propofol, and a combination anesthetic on bleeding and surgical field visualization during ESS.

Main Methods:

• A prospective, randomized controlled trial involving 70 patients undergoing ESS.
• Patients were assigned to desflurane, propofol, or a combination anesthetic, with remifentanil used for controlled hypotension.
• Bleeding scores, rates, and hemodynamic parameters were recorded.

Main Results:

• No significant differences were observed in bleeding rates, bleeding scores, surgery duration, or hemodynamic parameters among the three anesthetic groups.
• The desflurane group required lower remifentanil infusion rates compared to the propofol group.
• Bleeding score correlated with patient height and Lund-MacKay score; bilateral surgeries prolonged operating time.

Conclusions:

• Propofol does not provide an advantage over desflurane for improving surgical field visualization in ESS when controlled hypotension is achieved with remifentanil.
• Anesthetic selection may not be a primary determinant of surgical field quality in this context.