The Effect of the Method of Airway Management During Endoscopic Sinus Surgery Procedures on the Intraoperative Bleeding
https://doi.org/10.21292/2078-5658-2022-19-2-32-39
Abstract
The objective: to conduct a comparative assessment of the severity of intraoperative bleeding with different methods of airway management (using a laryngeal mask and endotracheal tube) during endoscopic rhinosinussurgical procedures.
Subjects and Methods. A prospective randomized cohort single-center study of 160 cases of endoscopic rhinosinussurgical procedures under general anesthesia was conducted.
Tracheal intubation (TI) was used in 79 cases (Group 1), a laryngeal mask (LM) – in 81 (Group 2). The evaluation criteria in the groups included the bleeding intensity (BI) by 6-point scale of average categories (Fromme-Boezaart Score), indicators characterizing the state of blood circulation during surgery: HR, BPsys., BPdiast., MAP, and perfusion index.
Results. Significantly lower BI values were observed in Group 2 at all time points of the study (at the 10th, 30th and 60th minute of surgery). This was due both to using a laryngeal mask, and to lower HR, BPsys., BPdiast, and MAP.
Conclusion. The use of a laryngeal mask for airway management during general anesthesia in endoscopic rhinosinussurgical procedures helps to reduce the intensity of surgical field bleeding.
About the Authors
V. E. Pavlov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Vladimir E. Pavlov, Assistant of Anesthesiology and Intensive Care Department
Phone: +7 (812) 338-70-19
6-8, Lva Tolstogo St., St. Petersburg, 197022
Yu. S. Polushin
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Yury S. Polushin, Academician of RAS, Professor, Head of Anesthesiology and Intensive Care Department, Head of Research Clinical Center of Anesthesiology and Intensive Care
6-8, Lva Tolstogo St., St. Petersburg, 197022
L. V. Kolotilov
St. Joseph's University, St. Joseph's College of Health and Allied Sciences
United Republic of Tanzania
United Republic of Tanzania
Leonid V. Kolotilov, Doctor of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department
Dar es Salaam
S. A. Karpishchenko
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Sergey A. Karpishchenko, Doctor of Medical Sciences, Professor, Head of Otorhinolaryngology Department
Phone: +7 (812) 338-70-19
6-8, Lva Tolstogo St., St. Petersburg, 197022
References
1. Karpishchenko S.A., Aleksandrov A.N., Bolozneva E.V. et al. Tactics of endoscopic endonasal treatment in frontal sinus pathology. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae, 2018, vol. 24, no. 3, pp. 96-100. (In Russ.)
2. Kolotilov L.V., Filimonov S.V., Pavlov V.E. et al. Mestnaya i obshchaya anesteziya v otorinolaringologii. [Local and general anesthesia in otorhinolaryngology]. St. Petersburg, Dialog Publ., 2017, pp. 52-53.
3. Kursov S.V. Perfusion index in anesthesiology and intensive therapy practice (literature review). Meditsina Neotlozhnykh Sostoyaniy, 2015, no. 7 (70), pp. 20-25. (In Russ.)
4. Pavlov V.E., Karpishchenko S.A. Intravenous use of lidocaine as part of general combined anesthesia in rhinosurgery. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae, 2018, vol. 24, no. 3, pp. 1-8. (In Russ.)
5. Pavlov V.E., Polushin Yu.S., Kolotilov L.V. Anesthetic possibilities for controlling intraoperative bleeding during endoscopic rhinosinus surgery. Messenger of Anesthesiology and Resuscitation, 2022, vol. 19, no. 1, pp. 75-81. (In Russ.) doi: 10.21292/2078-5658-2022-19-1-75-81.
6. Amorocho M.C., Fat I. Anesthetic Techniques in Endoscopic Sinus and Skull Base Surgery. Otolaryngol. Clin. North Am., 2016, vol. 49, no. 3, pp. 531–547. doi: 10.1016/j.otc.2016.03.004.
7. Atef A., Fawaz A. Comparison of laryngeal mask with endotracheal tube for anesthesia in endoscopic sinus surgery. Am. J. Rhinol., 2008, vol. 22, no. 6, pp. 653–657. doi: 10.2500/ajr.2008.22.3247.
8. Boezaart A.P., van der Merwe J., Coetzee A. Comparison of sodium nitroprusside- and esmolol-induced controlled hypotension for functional endoscopic sinus surgery. Can. J. Anaesth., 1995, vol. 42, no. 5, pt. 1, pp. 373–376. doi: 10.1007/BF03015479.
9. Di Mauro R., Lucci F., Martino F. et al. The role of intraoperative stroke volume variation on bleeding during functional endoscopic sinus surgery. Minerva Anestesiologica, 2018, vol. 84, no. 11, pp. 1246–1253. doi: 10.23736/S0375-9393.18.12401-1.
10. Drozdowski A., Sieśkiewicz A., Siemiatkowski A. Współczesne poglady na temat ograniczania krwawienia w polu operacyjnym w endoskopowej chirurgii zatok przynosowych [Reduction of intraoperative bleeding during functional endoscopic sinus surgery]. Anestezjol. Intens. Ter., 2011, vol. 43, no. 1, pp. 45-50.
11. Ha T.N., van Renen R.G., Ludbrook G.L. et al. The effect of blood pressure and cardiac output on the quality of the surgical field and middle cerebral artery blood flow during endoscopic sinus surgery. Int. Forum Allergy Rhinol., 2016, vol. 6, no. 7, pp. 701–709. doi: 10.1002/alr.21728.
12. Kleinschmidt S. Hat die kontrollierte Hypotension einen Stellenwert im Rahmen fremdblutsparender Verfahren? Anaesthesist., 2001, vol. 50, pp. S39–S42. doi:10.1007/s001010170009.
13. Lima A.P., Beelen P., Bakker J. Use of a peripheral perfusion index derived from the pulse oximetry signal as a noninvasive indicator of perfusion. Crit. Care Med., 2002, vol. 30, no. 6, pp. 1210–1213. doi: 10.1097/00003246-200206000-00006.
14. Seredyka-Burduk M., Burduk P.K., Wierzchowska M. et al. Ophthalmic complications of endoscopic sinus surgery. Braz. J. Otorhinolaryngol., 2017, vol. 83, no. 3, pp. 318–323. doi: 10.1016/j.bjorl.2016.04.006.
15. Stammberger H. Endoscopic endonasal surgery – concepts in treatment of recurring rhinosinusitis. Part I. Anatomic and pathophysiologic considerations. Otolaryngol. Head Neck Surg., 1986, vol. 94, no. 2, pp. 143–147. doi: 10.1177/019459988609400202.
16. Stammberger H. Endoscopic endonasal surgery – concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngol. Head Neck Surg., 1986, vol. 94, no. 2, pp. 147–156. doi: 10.1177/019459988609400203.
17. Thongrong C., Kasemsiri P., Carrau R.L. et al. Control of bleeding in endoscopic skull base surgery: current concepts to improve hemostasis. ISRN Surg., 2013, vol. 2013, pp. 191543. doi: 10.1155/2013/191543.
18. Wilson I.G., Fell D., Robinson S.L. et al. Cardiovascular responses to insertion of the laryngeal mask. Anaesthesia, 1992, vol. 47, no. 4, pp. 300–302. doi: 10.1111/j.1365-2044.1992.tb02168.x.
19. Wormald P.J., van Renen G., Perks J. The effect of the total intravenous anesthesia compared with inhalational anesthesia on the surgical field during endoscopic sinus surgery. Am. J. Rhinol., 2005, vol. 19, no. 5, pp. 514-520.
Review
For citations:
Pavlov V.E., Polushin Yu.S., Kolotilov L.V., Karpishchenko S.A. The Effect of the Method of Airway Management During Endoscopic Sinus Surgery Procedures on the Intraoperative Bleeding. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2022;19(2):32-39. (In Russ.) https://doi.org/10.21292/2078-5658-2022-19-2-32-39
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