Korean J Anesthesiol.  2012 Oct;63(4):302-307. 10.4097/kjae.2012.63.4.302.

Comparison of surgical conditions during propofol or desflurane anesthesia for endoscopic sinus surgery

• Cho K
• Lee JY
• Park SK
• Cheong SH
• Lee KM
• Lim SH
• Lee JH
• Kim MH
• Kim HT
• Park JK

• KMID: 1767167
• DOI: http://doi.org/10.4097/kjae.2012.63.4.302

Abstract

BACKGROUND
Reduction of intraoperative bleeding is necessary to achieve the ideal surgical field for the endoscopic sinus surgery (ESS). Intraoperative intra nasal bleeding is influenced by various anesthetics. This study compared surgical field condition between propofol/remifentanil (PR) based anesthesia and desflurane/remifentanil (DR) based anesthesia.
METHODS
American Society of Anesthesiologists physical status class I or II patients undergoing ESS were randomly assigned to group PR (n = 36) or group DR (n = 32). The extent of the preoperative surgical lesion was classified as high (> 12) and low (< or = 12) Lund-Mackay (LM) scores according to the computed tomography findings. The target mean blood pressure was maintained at 70-80 mmHg. Only one surgeon was involved in rating the visibility of the surgical field on a numeric rating scale (NRS) every 10 minutes.
RESULTS
There was a different surgical field grade from PR to DR. The mean (SD) surgical field score of NRS for the PR and DR was 2.3 (0.57) and 2.7 (0.67), respectively (P = 0.006). Especially in the high-LM score patients, the mean (SD) of surgical field score for the PR and DR was 2.4 (0.67) and 3.0 (0.63), respectively (P = 0.012).
CONCLUSIONS
In the high-LM score patients, PR based anesthesia resulted in better surgical field condition for ESS than DR based anesthesia. In ESS, PR based anesthesia is considered to be helpful.

Keyword

Desflurane; Propofol; Remifentanil; Sinusitis

MeSH Terms

Anesthesia
Anesthetics
Blood Pressure
Epistaxis
Hemorrhage
Humans
Isoflurane
Piperidines
Propofol
Sinusitis
Anesthetics
Isoflurane
Piperidines
Propofol