Blood loss during endoscopic sinus surgery with propofol or sevoflurane: A randomized clinical trial

Mohamad Chaaban, Fuad M. Baroody, Ori Gottlieb, Robert M. Naclerio

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Importance: Total intravenous anesthesia (TIVA) with propofol has been associated with reduced operative time, decreased perioperative risks, and decreased intraoperative blood loss compared with inhalational anesthesia (IA). During endoscopic sinus surgery (ESS), reduced bleeding from the mucosal surfaces could improve visualization of the anatomy and decrease the risk of serious complications. Objective: To compare blood loss during ESS between patients receiving TIVA with propofol and those receiving IA with sevoflurane. Design, Setting, and Participants: Prospective, randomized study of 33 patients undergoing ESS in an academic medical center. Interventions: Patients received either TIVA or IA. Main Outcomes and Measures: The primary outcome was rate of blood loss in milliliters per hour. The secondary outcomes included the quality of visibility measured by the surgeon's numeric rating score, ease of anesthesia as measured by the anesthesiologist's numeric rating score, and total blood loss. Results: The mean (SEM) blood loss per hour in the TIVA group was 78.5 (14) mL/h, and in the IA group it was 80.3 (17) mL/h (P = .93). A post hoc subgroup analysis found that in patients with a Lund-Mackay score of 12 or lower, the propofol TIVA group had a lower rate of blood loss compared with the sevoflurane IA group (mean blood loss, approximately 18 mL/h vs approximately 99 mL/h). The anesthesiologist's numeric rating score was significantly higher (indicating greater ease of performance) in the IA group than in the TIVA group. There was no statistically significant difference in the surgical numeric rating score between the 2 groups. Conclusions and Relevance: In this comparative study, our results did not show any difference in blood loss and surgical conditions between the TIVA and IA groups. Even further study is not likely to show a difference in blood loss between TIVA and IA during ESS.

Original languageEnglish (US)
Pages (from-to)510-514
Number of pages5
JournalJAMA Otolaryngology - Head and Neck Surgery
Volume139
Issue number5
DOIs
StatePublished - May 2013
Externally publishedYes

Fingerprint

Intravenous Anesthesia
Propofol
Anesthesia
Randomized Controlled Trials
Surgical Blood Loss
sevoflurane
Operative Time
Blood Group Antigens
Anatomy
Outcome Assessment (Health Care)
Prospective Studies
Hemorrhage

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

Blood loss during endoscopic sinus surgery with propofol or sevoflurane : A randomized clinical trial. / Chaaban, Mohamad; Baroody, Fuad M.; Gottlieb, Ori; Naclerio, Robert M.

In: JAMA Otolaryngology - Head and Neck Surgery, Vol. 139, No. 5, 05.2013, p. 510-514.

Research output: Contribution to journalArticle

Chaaban, Mohamad ; Baroody, Fuad M. ; Gottlieb, Ori ; Naclerio, Robert M. / Blood loss during endoscopic sinus surgery with propofol or sevoflurane : A randomized clinical trial. In: JAMA Otolaryngology - Head and Neck Surgery. 2013 ; Vol. 139, No. 5. pp. 510-514.
@article{3de9ec3ceb844c55a45da2176c1b0819,
title = "Blood loss during endoscopic sinus surgery with propofol or sevoflurane: A randomized clinical trial",
abstract = "Importance: Total intravenous anesthesia (TIVA) with propofol has been associated with reduced operative time, decreased perioperative risks, and decreased intraoperative blood loss compared with inhalational anesthesia (IA). During endoscopic sinus surgery (ESS), reduced bleeding from the mucosal surfaces could improve visualization of the anatomy and decrease the risk of serious complications. Objective: To compare blood loss during ESS between patients receiving TIVA with propofol and those receiving IA with sevoflurane. Design, Setting, and Participants: Prospective, randomized study of 33 patients undergoing ESS in an academic medical center. Interventions: Patients received either TIVA or IA. Main Outcomes and Measures: The primary outcome was rate of blood loss in milliliters per hour. The secondary outcomes included the quality of visibility measured by the surgeon's numeric rating score, ease of anesthesia as measured by the anesthesiologist's numeric rating score, and total blood loss. Results: The mean (SEM) blood loss per hour in the TIVA group was 78.5 (14) mL/h, and in the IA group it was 80.3 (17) mL/h (P = .93). A post hoc subgroup analysis found that in patients with a Lund-Mackay score of 12 or lower, the propofol TIVA group had a lower rate of blood loss compared with the sevoflurane IA group (mean blood loss, approximately 18 mL/h vs approximately 99 mL/h). The anesthesiologist's numeric rating score was significantly higher (indicating greater ease of performance) in the IA group than in the TIVA group. There was no statistically significant difference in the surgical numeric rating score between the 2 groups. Conclusions and Relevance: In this comparative study, our results did not show any difference in blood loss and surgical conditions between the TIVA and IA groups. Even further study is not likely to show a difference in blood loss between TIVA and IA during ESS.",
author = "Mohamad Chaaban and Baroody, {Fuad M.} and Ori Gottlieb and Naclerio, {Robert M.}",
year = "2013",
month = "5",
doi = "10.1001/jamaoto.2013.2885",
language = "English (US)",
volume = "139",
pages = "510--514",
journal = "JAMA Otolaryngology - Head and Neck Surgery",
issn = "2168-6181",
publisher = "American Medical Association",
number = "5",

}

TY - JOUR

T1 - Blood loss during endoscopic sinus surgery with propofol or sevoflurane

T2 - A randomized clinical trial

AU - Chaaban, Mohamad

AU - Baroody, Fuad M.

AU - Gottlieb, Ori

AU - Naclerio, Robert M.

PY - 2013/5

Y1 - 2013/5

N2 - Importance: Total intravenous anesthesia (TIVA) with propofol has been associated with reduced operative time, decreased perioperative risks, and decreased intraoperative blood loss compared with inhalational anesthesia (IA). During endoscopic sinus surgery (ESS), reduced bleeding from the mucosal surfaces could improve visualization of the anatomy and decrease the risk of serious complications. Objective: To compare blood loss during ESS between patients receiving TIVA with propofol and those receiving IA with sevoflurane. Design, Setting, and Participants: Prospective, randomized study of 33 patients undergoing ESS in an academic medical center. Interventions: Patients received either TIVA or IA. Main Outcomes and Measures: The primary outcome was rate of blood loss in milliliters per hour. The secondary outcomes included the quality of visibility measured by the surgeon's numeric rating score, ease of anesthesia as measured by the anesthesiologist's numeric rating score, and total blood loss. Results: The mean (SEM) blood loss per hour in the TIVA group was 78.5 (14) mL/h, and in the IA group it was 80.3 (17) mL/h (P = .93). A post hoc subgroup analysis found that in patients with a Lund-Mackay score of 12 or lower, the propofol TIVA group had a lower rate of blood loss compared with the sevoflurane IA group (mean blood loss, approximately 18 mL/h vs approximately 99 mL/h). The anesthesiologist's numeric rating score was significantly higher (indicating greater ease of performance) in the IA group than in the TIVA group. There was no statistically significant difference in the surgical numeric rating score between the 2 groups. Conclusions and Relevance: In this comparative study, our results did not show any difference in blood loss and surgical conditions between the TIVA and IA groups. Even further study is not likely to show a difference in blood loss between TIVA and IA during ESS.

AB - Importance: Total intravenous anesthesia (TIVA) with propofol has been associated with reduced operative time, decreased perioperative risks, and decreased intraoperative blood loss compared with inhalational anesthesia (IA). During endoscopic sinus surgery (ESS), reduced bleeding from the mucosal surfaces could improve visualization of the anatomy and decrease the risk of serious complications. Objective: To compare blood loss during ESS between patients receiving TIVA with propofol and those receiving IA with sevoflurane. Design, Setting, and Participants: Prospective, randomized study of 33 patients undergoing ESS in an academic medical center. Interventions: Patients received either TIVA or IA. Main Outcomes and Measures: The primary outcome was rate of blood loss in milliliters per hour. The secondary outcomes included the quality of visibility measured by the surgeon's numeric rating score, ease of anesthesia as measured by the anesthesiologist's numeric rating score, and total blood loss. Results: The mean (SEM) blood loss per hour in the TIVA group was 78.5 (14) mL/h, and in the IA group it was 80.3 (17) mL/h (P = .93). A post hoc subgroup analysis found that in patients with a Lund-Mackay score of 12 or lower, the propofol TIVA group had a lower rate of blood loss compared with the sevoflurane IA group (mean blood loss, approximately 18 mL/h vs approximately 99 mL/h). The anesthesiologist's numeric rating score was significantly higher (indicating greater ease of performance) in the IA group than in the TIVA group. There was no statistically significant difference in the surgical numeric rating score between the 2 groups. Conclusions and Relevance: In this comparative study, our results did not show any difference in blood loss and surgical conditions between the TIVA and IA groups. Even further study is not likely to show a difference in blood loss between TIVA and IA during ESS.

UR - http://www.scopus.com/inward/record.url?scp=84878262866&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878262866&partnerID=8YFLogxK

U2 - 10.1001/jamaoto.2013.2885

DO - 10.1001/jamaoto.2013.2885

M3 - Article

C2 - 23681034

AN - SCOPUS:84878262866

VL - 139

SP - 510

EP - 514

JO - JAMA Otolaryngology - Head and Neck Surgery

JF - JAMA Otolaryngology - Head and Neck Surgery

SN - 2168-6181

IS - 5

ER -