Comparison of propofol and sevoflurane anesthesia by means of blood loss during endoscopic sinus surgery

OBJECTIVE: The purpose of the present investigation is to examine whether induced hypotension with propofol or sevoflurane anesthesia improves the dryness of surgical field in endoscopic sinus surgery (ESS).

METHODS: The study was performed between 1999 and 2002 in Celal Bayar University and Afyon Kocatepe University Hospitals, Turkey. Thirty-two patients (American Society of Anesthesiologists physical status I and III) with chronic sinusitis undergoing outpatient endoscopic sinus surgery under general anesthesia were studied to determine if anesthetic technique had an impact on estimated blood loss. The patients were allocated randomly into 2 groups. None of the patients were premedicated. Anesthesia was induced with propofol in both groups and maintained with propofol/fentanyl in the first group and sevoflurane/fentanyl in the second group. In both groups, controlled hypotension was used to improve surgical condition.

RESULTS: There were no differences between the duration of surgery and intraoperative mean arterial blood pressure when comparing the 2 groups. The average estimated blood loss in the propofol group was 128.1 +/- 37.3 ml compared with an average estimated blood loss of 296.9 +/- 97.8 ml in the sevoflurane group (p<0.01).

CONCLUSION: General anesthesia based on propofol infusion may have the advantage of decreased bleeding compared with conventional inhalation agents. Therefore, making endoscopic surgery technically easier and safer by improving endoscopic visualization of the surgical field.