Intraoperative Bleeding Control with Terlipressin in Functional Endoscopic Sinus Surgery

Area of Science:

• Otolaryngology
• Surgical Innovation
• Pharmacology

Background:

• Intraoperative bleeding poses challenges in functional endoscopic sinus surgery (FESS).
• Effective hemostatic agents are crucial for surgical safety and visibility.
• Terlipressin's potential for bleeding reduction in FESS requires evaluation.

Purpose of the Study:

• To assess the efficacy of terlipressin in reducing intraoperative bleeding during FESS.
• To compare bleeding intensity and hemodynamic parameters between patients receiving terlipressin and those not.

Main Methods:

• A prospective, randomized, single-blinded study involving 74 FESS cases under general anesthesia.
• Patients were divided into two groups: terlipressin (200 μg) and control (no terlipressin).
• Bleeding intensity (BI), heart rate (HR), mean blood pressure (MBP), and perfusion index (PI) were recorded.

Main Results:

• The terlipressin group showed significantly reduced BI and PI compared to the control group.
• Mean blood pressure was higher in the terlipressin group, while heart rate remained similar.
• Terlipressin use was associated with a significantly lower risk of significant bleeding (OR 0.028 at 30 min, OR 0.140 at 60 min).

Conclusions:

• Low-dose terlipressin (200 μg) effectively reduces intraoperative bleeding in FESS.
• Terlipressin administration did not compromise blood pressure during general anesthesia for FESS.
• Terlipressin is a promising agent for improving hemostasis in FESS procedures.