Comparison of Bleeding Extent in Propofol-Remifentanil Versus Isoflouran Remifentanil Anesthetic Procedures in Functional Endoscopy Sinus Surgery(FESS) in Rasoul-e-Akram Hospital

Anesthetic procedure is an important factor in the extent of blood loss during operation and can determine pre and post-operative complications. Finding an anesthetic procedure to reduce the extent of blood loss is a major goal for most surgeons. This study was undertaken to compare two anesthetic procedures and their extent of blood loss in patients undergoing endoscopic sinus surgery. 46 ASA I patients, who referred to ENT ward of Rasoul-e-Akram Hospital for endoscopic sinus surgery, were selected and then randomly assigned into two groups of 23 patients each. In the first group the induction of anesthesia was accomplished by propofol and remifentanil and cis-atracarium. Maintenance of anesthesia in this group was accomplished by using propofol and remifentanil infusion. In the second group the induction of anesthesia was accomplished by using propofol and remifentanil and cis-atracurium. Maintenance of anesthesia in this group was accomplished by using isoflouran and infusion of remifentanil. All patients received 7 ml/kg crystalloid solution before induction of anesthesia and their systolic blood pressure was maintained at 90 mmHg using TNG if needed. Blood loss determinants were: the extent of blood loss in suction(per bottle), the extent of blood in the surgical field, pre and post-operation hemoglobin levels, and surgeon’s satisfaction of blood loss extent describing as: very extensive, obvious but acceptable and mild. The obtained results showed that there was no significant statistical difference in the extent of blood loss between two groups. There was also no significant statistical difference in pre and post-operation hemoglobin levels between two groups. In summary, the two procedures remarkably reduced the extent of bleeding(28cc±6), but this extent is not statistically different between the two groups.