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BJA Advance Access published online on November 3, 2007
British Journal of Anaesthesia, doi:10.1093/bja/aem304
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Comparison of surgical conditions during propofol or sevoflurane anaesthesia for endoscopic sinus surgery

H. J. Ahn1, S.-K. Chung2, H.-J. Dhong2, H. Y. Kim2, J. H. Ahn1, S. M. Lee1, T. S. Hahm1 and J. K. Kim1,*

1 Department of Anaesthesiology and Pain Medicine
2 Department of Otorhinolaryngology, Samsung Medical Center, Sungkyunkwan University School of Medicine 135–710, 50 Ilwon-dong, Kangnam-ku, Seoul, Korea

* Corresponding author. E-mail: jkane.kim{at}samsung.com

Background: Endoscopic sinus surgery (ESS) is often affected by intra-nasal bleeding, which can be influenced by various anaesthetics and preoperative conditions. This study compared the surgical condition and the amount of intra-nasal bleeding between patients given sevoflurane/remifentanil (SR) and propofol/remifentanil (PR) anaesthesia.

Methods: ASA I or II patients undergoing ESS were randomly assigned to group SR (n=20) or group PR (n=20). The extent of the preoperative surgical lesion was classified as high (>12) and low Lund–Mackay (LM) (≤12) scores according to the computed tomography findings. The amount of intraoperative blood loss was calculated from the patients’ haemoglobin (Hb) and the amount of blood in the suction canister. The surgeons rated the visibility of the surgical field on a numeric rating scale (NRS).

Results: In the high-LM score patients, the median (1st/3rd quartiles) blood loss for the SR and PR groups was 135 (121/222) and 19 (8/71) ml h–1, respectively (P<0.01), and the mean (SD) of NRS was 5.8 (2.3) and 2.3 (1.0), respectively (P<0.05). However, in patients with low-LM score, both blood loss and NRS scores were not different between groups SR and PR.

Conclusions: In the high-LM score patients, PR anaesthesia results in less blood loss and a better surgical conditions for ESS than SR anaesthesia.

Keywords: anaesthesia, otolaryngological; anaesthetics i.v., propofol; anaesthetics volatile, sevoflurane; blood, loss


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