• Minerva anestesiologica · Nov 2018

    Randomized Controlled Trial Comparative Study

    The role of intraoperative stroke volume variation on bleeding during functional endoscopic sinus surgery.

    • Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, and Mario Dauri.
    • Unit of Otorhinolaryngology, Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy - robertadimauro@hotmail.it.
    • Minerva Anestesiol. 2018 Nov 1; 84 (11): 1246-1253.

    BackgroundFunctional endoscopic sinus surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimize bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which hemodynamic parameter better correlates with surgical bleeding.MethodsWe enrolled 55 patients undergoing FESS. Inclusion criteria: male or female with chronic rhinosinusitis (CRS), older than 18 years, ASA I to III and primary surgery. Exclusion criteria: ASA>III, cerebrovascular and cardiac disorders, supraventricular tachycardia, renal or hepatic diseases, non-treated arterial hypertension, beta-blocking agent therapy, platelet-inhibiting agent or anticoagulant therapy, coagulopathy, pregnancy, clotting disorders, presence of neoplastic lesions and history of cranio-facial surgery. We used standard ASA plus ClearSight to assess hemodynamic parameters. Surgical procedures were performed by one surgeon and divided in ten surgical times (from T0 to T9). Intraoperative bleeding was assessed using the Fromme-Boezaart Scale.ResultsAnalysis between all the hemodynamic parameters registered and the Fromme-Boezaart Score showed a negative correlation between surgical bleeding and stroke volume variation (SVV) only. When dichotomizing according to Fromme-Boezaart Score (above or below 2), SVV was the only parameter which showed significant differences between groups. A cut-off of 12.5% in SVV is optimal to distinguish the group with the better surgical visibility from the group with the worst one.ConclusionsTargeting SVV larger than 12% achieves a possible reduction of the intraoperative bleeding in patients undergoing FESS.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.