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VOLUME 4 , ISSUE 1 ( January-April, 2011 ) > List of Articles

RESEARCH ARTICLE

Hypotensive Anesthesia with Propofol Infusion Pump: A Boon for Endoscopic Sinus and Nasal Polyps Surgery

Keywords : Endoscopic sinus surgery, Propofol, Hypotensive anesthesia, Intraoperative bleeding

Citation Information : Hypotensive Anesthesia with Propofol Infusion Pump: A Boon for Endoscopic Sinus and Nasal Polyps Surgery. Clin Rhinol An Int J 2011; 4 (1):5-8.

DOI: 10.5005/jp-journals-10013-1062

Published Online: 01-04-2011

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

Background

Successful outcome of endoscopic sinus surgery depends on complete visualization of the operative field and intraoperative control of bleeding. Major disadvantage of general anesthesia is the increased bleeding encountered, which can interfere with optimum visualization of the intranasal anatomy unless hypotensive methods are used.

Objectives

To study the different anesthetic techniques in relation to their impact on blood loss and duration of surgery. The role of propofol was also evaluated.

Design

Department of Anesthesia and ENT, Head and Neck Surgery, KVG Medical College and Hospital, Sullia, Karnataka, India.

Materials and methods

213 cases of endoscopic sinus surgeries done for nasal polyposis, sinusitis, dacryocystitis and septorhinoplasties under local and general anesthesia were evaluated between June 2009 and August 2010.

Result

A good operative field was seen with propofol anesthesia compared to halothane anesthesia. The problems of fogging and frequent suctioning were lesser with propofol hypotensive anesthesia.

Conclusion

Hypotensive anesthesia using propofol infusion is the anesthesia of choice for extensive nasal polyposis. Propofol when used both for induction as well as maintenance of general anesthesia in endoscopic sinus surgeries significantly reduces the blood loss, thereby improving the visibility of the endonasal structures and minimizes the chance of complications related to endoscopic sinus surgery.


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  1. Functional endoscopic sinus surgery: Evaluation, surgery and follow up of 250 patients. Laryngoscope 1990;100: 79-84.
  2. Treatment of nasal surgery complications. Ann of Plast Surg 1993;30:80-88.
  3. Fatal and other major complications of endoscopic sinus surgery. Laryngoscope 1991;101:349-54.
  4. T Metin Hypotensive Anesthesia for Endoscopic Sinus Surgery and Septorhinoplasty: A Comparison of Propofol-Alfentanil Infusion and Isoflurane. T Klin J Med Res 2000;(18):18:98-104.
  5. Functional endoscopic sinus surgery; morbidity and early results. Henry Ford Hosp Med J 1990;38:508.
  6. Clinical assessment of anesthesia and estimated blood loss during maxillary sinus surgery. Anest Prog 1989;36:242-48.
  7. A practice of anesthesia Chicago, Year book Medical 1984.
  8. Propofol for maintenance of general anesthesia: A technique to limit blood loss during endoscopic sinus surgery. Am J Otolaryngol 1993;4:262-66.
  9. Comparison of functional endoscopic sinus surgery under local and general anestesia. Ann Oto Rhin Laryn 1993;102:289-93.
  10. Comparison of sodium nitroprusside and esmolol- induced controlled hypotension for functional endoscopic sinus surgery. Can J Anaesth 1995;42:373-76.
  11. Endoscopic total sphenoethmoidectomy. Otolaryngol Clin North Am 1989;22:727-32.
  12. Complications of endoscopic intranasal ethmoidectomy. Laryncoscope 1987;97:1270-73.
  13. Cardiovascular responses to endotracheal intubation during four anaesthetic techniques. Acta Anaesthesiol Scand 1984;28:563-66.
  14. Circulatory responses to laryncoscopy; the comperative effects of placebo, fentanyl and esmolol. Can J Anaesth 1989;36: 301-30.
  15. Complications in endoscopic intranasal ethmoidectomy. An update Laryngoscope 1989;99:686-90.
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