Possibilities of the anesthesiologist to influence the clarity of the operating field in endonasal surgery

Česká verzia

Authors: M. Parma ¹; J. Lubojacký ^2,3 ; M. Frelich ^1,4; V. Vodička ¹; H. Straková ¹; P. Matoušek ^2,3 ; O. Jor ^1,4
Authors place of work: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Ostrava ¹; Klinika otorinolaryngologie a chirurgie hlavy a krku, Fakultní nemocnice Ostrava ²; Katedra kraniofaciálních oborů, Lékařská fakulta, Ostravská univerzita, Ostrava ³; Katedra intenzivní medicíny, urgentní medicíny a forenzních oborů, Lékařská fakulta, Ostravská univerzita, Ostrava ⁴
Published in the journal: Anest. intenziv. Med., 33, 2022, č. 1, s. 45-50
Category: Review Article

Summary

Endoscopic nasal surgery deals with operations on the nose and paranasal sinuses. The nose and paranasal sinuses are richly vascularly supplied. Mucosal bleeding into the surgical field is therefore common and can be significant. The surgeon works in very cramped spaces with difficult identification of subtle differences in color, where even minimal bleeding can obscure the operating field. Poor clarity in the operated area makes the operation more difficult and increases the risk of complications. The aim of this review work is to provide a comprehensive view of the possibilities of influencing the clarity of the operating field by an anesthesiologist.

Keywords:

functional endoscopic sinus surgery – FESS – bleeding control – clarity of the operating field – controlled hypotension

Zdroje

1. Rahman T, Alam MM, Ahmed S, Karim MA, Rahman M, Wahiduzzaman M. Outcome of Endoscopic Sinus Surgery in the Treatment of Chronic Rhinosinusitis. Mymensingh Med J. 2016 Apr;25(2):261-270. PMID: 27277358.

2. Humphreys IM, Hwang PH. Avoiding Complications in Endoscopic Sinus Surgery. Otolaryngol Clin North Am. 2015 Oct;48(5):871–881. doi: 10.1016/j.otc.2015. 05. 013. Epub 2015 Jun 24. PMID: 26117296.

3. DITZLER JW, ECKENHOFF JE. A comparison of blood loss and operative time in certain surgical procedures completed with and without controlled hypotension. Ann Surg. 1956 Mar;143(3):289-293. doi: 10.1097/00000658-195603000-00001. PMID: 13303061; PMCID: PMC1465113.

4. Petrozza PH. Induced hypotension. Int Anesthesiol Clin. 1990 Fall;28(4):223–229. doi: 10.1097/00004311-199002840-00008. PMID: 2228278.

5. Abdelgalel EF. Controlled hypotensive anesthesia for endoscopic endonasal repair of cerebrospinal fluid rhinorrhea: A comparison between clevidipine and esmolol: Randomized controlled study. Egyptian Journal of Anaesthesia. 2018,34(1),1-7.

6. Boezaart AP, van der Merwe J, Coetzee A. Comparison of sodium nitroprusside- and esmolol‑ induced controlled hypotension for functional endoscopic sinus surgery. Can J Anaesth. 1995 May;42(5 Pt 1):373-376. doi: 10.1007/BF03015479. PMID: 7614641.

7. Puthenveettil N, Rajan S, Kumar L, Nair SG. A comparison of effects of oral premedication with clonidine and metoprolol on intraoperative hemodynamics and surgical conditions during functional endoscopic sinus surgery. Anesth Essays Res. 2013 Sep–Dec;7(3): 371-375. doi: 10.4103/0259-1162.123244. PMID: 25885986; PMCID: PMC4173566.

8. Sanders JS, Mark AL, Ferguson DW. Importance of aortic baroreflex in regulation of sympathetic responses during hypotension. Evidence from direct sympathetic nerve recordings in humans. Circulation. 1989 Jan;79(1):83-92. doi: 10.1161/01.cir.79. 1. 83. PMID: 2910547.

9. Sellgren J, Ejnell H, Elam M, Pontén J, Wallin BG. Sympathetic muscle nerve activity, peripheral blood flows, and baroreceptor reflexes in humans during propofol anesthesia and surgery. Anesthesiology. 1994 Mar;80(3):534-544. doi: 10.1097/00000542-199403000-00009. PMID: 8141450.

10. Reich DL, Hossain S, Krol M, Baez B, Patel P, Bernstein A, Bodian CA. Predictors of hypotension after induction of general anesthesia. Anesth Analg. 2005 Sep;101(3):622-628. doi: 10.1213/01.ANE.0000175214.38450. 91. PMID: 16115962.

11. Degoute CS, Ray MJ, Manchon M, Dubreuil C, Banssillon V. Remifentanil and controlled hypotension; comparison with nitroprusside or esmolol during tympanoplasty. Can J Anaesth. 2001 Jan;48(1):20-7. doi: 10.1007/BF03019809. PMID: 11212044.

12. Mengistu AM, Wolf MW, Boldt J, Röhm KD, Suttner SW, Piper SN. Influence of controlled hypotension using esmolol and sodium nitroprusside on natriuretic peptides in patients undergoing endonasal sinus surgery. Eur J Anaesthesiol. 2007 Jun;24(6):529-534. doi: 10.1017/S0265021506002286. Epub 2007 Jan 23. Retraction in: Eur J Anaesthesiol. 2011 Jun;28(6):468. PMID: 17241506.

13. Blau WS, Kafer ER, Anderson JA. Esmolol is more effective than sodium nitroprusside in reducing blood loss during orthognathic surgery. Anesth Analg. 1992 Aug;75(2):172-178. doi: 10.1213/00000539-199208000-00004. PMID: 1352949.

14. Jacobi KE, Böhm BE, Rickauer AJ, Jacobi C, Hemmerling TM. Moderate controlled hypotension with sodium nitroprusside does not improve surgical conditions or decrease blood loss in endoscopic sinus surgery. J Clin Anesth. 2000 May;12(3):202-207. doi: 10.1016/s0952-8180(00)00145-8. PMID: 10869918.

15. Elsharnouby NM, Elsharnouby MM. Magnesium sulphate as a technique of hypotensive anaesthesia. Br J Anaesth. 2006 Jun;96(6):727-731. doi: 10.1093/bja/ael085. Epub 2006 May 2. PMID: 16670112.

16. Behnia R, Martin A, Koushanpour E, Brunner EA. Trimethaphan‑induced hypotension: effect on renal function. Can Anaesth Soc J. 1982 Nov;29(6):581-586. doi: 10.1007/BF03007745. PMID: 7139398.

17. Lang B, Zhang L, Lin Y, Zhang W, Li FS, Chen S. Comparison of effects and safety in providing controlled hypotension during surgery between dexmedetomidine and magnesium sulphate: A meta‑analysis of randomized controlled trials. PLoS One. 2020 Jan 8;15(1):e0227410. doi: 10.1371/journal.pone.0227410. PMID: 31914454; PMCID: PMC6949117.

18. Praveen K, Narayanan V, Muthusekhar MR, Baig MF. Hypotensive anaesthesia and blood loss in orthognathic surgery: a clinical study. Br J Oral Maxillofac Surg. 2001 Apr;39(2): 138-140. doi: 10.1054/bjom.2000.0593. PMID: 11286449.

19. Miłoński J, Zielińska‑Bliźniewska H, Golusiński W, Urbaniak J, Sobański R, Olszewski J. Effects of three different types of anaesthesia on perioperative bleeding control in functional endoscopic sinus surgery. Eur Arch Otorhinolaryngol. 2013 Jul;270(7):2045-2050. doi: 10.1007/s00405-012-2311-1. Epub 2012 Dec 22. PMID: 23263204; PMCID: PMC3669505.

20. Monk TG, Bronsert MR, Henderson WG, Mangione MP, Sum‑Ping ST, Bentt DR, Nguyen JD, Richman JS, Meguid RA, Hammermeister KE. Association between Intraoperative Hypotension and Hypertension and 30-day Postoperative Mortality in Noncardiac Surgery. Anesthesiology. 2015 Aug;123(2):307–319. doi: 10.1097/ALN.0000000000000756. Erratum in: Anesthesiology. 2016 Mar;124(3):741-742. PMID: 26083768.

21. Aronson S, Stafford‑Smith M, Phillips‑Bute B, Shaw A, Gaca J, Newman M; Cardiothoracic Anesthesiology Research Endeavors. Intraoperative systolic blood pressure variability predicts 30-day mortality in aortocoronary bypass surgery patients. Anesthesiology. 2010 Aug;113(2):305-312. doi: 10.1097/ALN.0b013e3181e07ee9. PMID: 20571360.

22. Mascha EJ, Yang D, Weiss S, Sessler DI. Intraoperative Mean Arterial Pressure Variability and 30-day Mortality in Patients Having Noncardiac Surgery. Anesthesiology. 2015 Jul;123(1):79-91. doi: 10.1097/ALN.0000000000000686. PMID: 25929547.

23. Wesselink EM, Kappen TH, Torn HM, Slooter AJC, van Klei WA. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth. 2018 Oct;121(4):706-721. doi: 10.1016/j.bja.2018. 04. 036. Epub 2018 Jun 20. PMID: 30236233.

24. Bijker JB, Persoon S, Peelen LM, Moons KG, Kalkman CJ, Kappelle LJ, van Klei WA. Intraoperative hypotension and perioperative ischemic stroke after general surgery: a nested case‑control study. Anesthesiology. 2012 Mar;116(3):658–664. doi: 10.1097/ALN.0b013e3182472320. PMID: 22277949.

25. van Waes JA, van Klei WA, Wijeysundera DN, van Wolfswinkel L, Lindsay TF, Beattie WS. Association between Intraoperative Hypotension and Myocardial Injury after Vascular Surgery. Anesthesiology. 2016 Jan;124(1):35-44. doi: 10.1097/ALN.0000000000000922. PMID: 26540148.

26. Sun LY, Wijeysundera DN, Tait GA, Beattie WS. Association of intraoperative hypotension with acute kidney injury after elective noncardiac surgery. Anesthesiology. 2015 Sep;123(3):515-523. doi: 10.1097/ALN.0000000000000765. PMID: 26181335.

27. Ping WD, Zhao QM, Sun HF, Lu HS, Li F. Role of tranexamic acid in nasal surgery: A systemic review and meta‑analysis of randomized control trial. Medicine (Baltimore). 2019 Apr;98(16):e15202. doi: 10.1097/MD.0000000000015202. PMID: 31008946; PMCID: PMC6494350.

28. Moffatt DC, McQuitty RA, Wright AE, Kamucheka TS, Haider AL, Chaaban MR. Evaluating the Role of Anesthesia on Intraoperative Blood Loss and Visibility during Endoscopic Sinus Surgery: A Meta‑analysis. Am J Rhinol Allergy. 2021 Sep;35(5):674-684. doi: 10.1177/1945892421989155. Epub 2021 Jan 21. PMID: 33478255.

29. Thongrong C, Kasemsiri P, Carrau RL, Bergese SD. Control of bleeding in endoscopic skull base surgery: current concepts to improve hemostasis. ISRN Surg. 2013 Jun 13;2013:191543. doi: 10.1155/2013/191543. PMID: 23844295; PMCID: PMC3697291.

30. Sia DI, Chalmers A, Singh V, Malhotra R, Selva D. General anaesthetic considerations for haemostasis in orbital surgery. Orbit. 2014 Feb;33(1):5-12. doi: 10.3109/01676830.2013.842250. Epub 2013 Oct 21. PMID: 24144180.

31. Parvizi A, Haddadi S, Faghih Habibi A, Nemati S, Akhtar N, Ramezani H. Dexmedetomidine Efficacy in Quality of Surgical Field During Endoscopic Sinus Surgery. Iran J Otorhinolaryngol. 2019 Sep;31(106):281-288. PMID: 31598495; PMCID: PMC6764817.

32. J N S, Kumar S, Vijay T. To Compare the Efficacy of Dexmedetomidine Versus Labetalol in Providing Controlled Hypotension in Functional Endoscopic Sinus Surgery. Anesth Pain Med. 2021 Feb 16;11(1):e108915. doi: 10.5812/aapm.108915. PMID: 34221935; PMCID: PMC8241463.

33. Shao H, Kuang LT, Hou WJ, Zhang T. Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial. BMC Anesthesiol. 2015 Apr 17;15:53. doi: 10.1186/s12871-015-0034-8. PMID: 25895497; PMCID: PMC4404629.