[Beta-blockers for reducing intraoperative bleeding during rhinosinusosurgical operations in elderly and senile...

With the ineffectiveness of conservative therapy of chronic rhinosinusitis in all age groups of patients, functional rhinosinusosurgical endoscopic interventions are now often used to do. The minimal bleeding is a necessary condition for their realization. There are reports of the use of beta-blockers for reducing surgical bleeding, but the possibility of their intravenous use in older patients has not been sufficiently studied. The aim of the work was to evaluate the effectiveness of intravenous metoprolol to reduce the bleeding intensity (BI) during rhinosinusosurgical interventions under general anesthesia in elderly and senile patients. The BI was assessed on the Fromme-Boezaart Score scale at different stages of the operation from the 10th to the 60th minute in two groups of patients: without (WM) and using metoprolol (M). It was shown that at the 30th minute of the operation BI was significantly lower in M group. Multivariate analysis of hemodynamic parameters demonstrated a direct relationship between heart rate (HR) and the development of bleeding. In the WM group, the probability of significant bleeding was 8,6 times higher. It has been shown that intraoperative intravenous use of metoprolol reduces the intensity of local bleeding during endoscopic rhinosinusosurgical operations.