• Fernando Gomez-Rivera, Davide Cattano, Uma Ramaswamy, Chirag B Patel, Alfonso Altamirano, Li-Xing Man, Amber Luong, Zhongxue Chen, Martin J Citardi, and Samer Fakhri.
• Dept of Otorhinolaryngology-Head and Neck Surgery, University of Texas Medical School at Houston, 6431 Fannin St, MSB 5.036, Houston, TX 77030, USA.
• Ann Oto Rhinol Laryn. 2012 Nov 1;121(11):725-32.

ObjectivesWe compared anesthesia with sevoflurane-remifentanil hydrochloride (SR) to total intravenous anesthesia with propofol-remifentanil hydrochloride (PR) in patients undergoing endoscopic sinus surgery for chronic rhinosinusitis in terms of sinonasal mucosal blood flow, the surgical field visualization score, and blood loss.MethodsWe performed a double-blinded prospective study at a tertiary care center in 23 adults scheduled to undergo endoscopic sinus surgery for chronic rhinosinusitis. The patients were randomized to receive SR or PR. The sinonasal mucosal blood flow was measured by optical rhinometry. The surgical field visualization score was based on the Boezaart scale.ResultsThe groups had similar clinical characteristics. During the 60- to 90-minute and 90- to 120-minute operative time windows, the blood flow was significantly greater in the PR group than in the SR group (p = 0.04 and p = 0.03, respectively). The amounts of blood loss in the PR and SR groups were 152.9 +/- 161.3 mL and 355.9 +/- 393.4 mL, respectively (p = 0.12). The median ratios of the surgical field visualization score to the number of sinuses operated on in the PR and SR groups were 2.1 and 1.8, respectively (p = 0.52).ConclusionsThe intraoperative blood flow, as determined by optical rhinometry, was significantly greater with anesthesia with PR than with anesthesia with SR, 1 hour into the procedure; however, this difference did not translate into differences in the amounts of operative blood loss or in the surgical field visualization scores.

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