The assessment of correlation between mean arterial pressure and intraoperative bleeding during endoscopic sinus surgery in patients with low heart rate
Journal Title: Otolaryngologia Polska - Year 2010, Vol 64, Issue 4
Abstract
Induced controlled hypotension is a standard method aimed at decreasing intraoperative bleeding and achieving good operative field conditions. Low hemodynamic parameters during the operation are related to increased risk of brain hypoperfusion and injury to hypoxia-sensitive nerve cells.The purpose of this study was to find the mean arterial pressure (MAP) that preserves good operative conditions at low heart rate (HR) during endoscopic sinus surgery.Material and method: Twenty eight patients ASA I–II were anesthetized using remifentanil and sevoflurane. The anesthetist was attempting to keep the heart rate around 60 b/min. tried to diminish the MAP gradually until good operative field conditions were achived. The surgeon blinded to the HR and MAP values rated the bleeding in the operative field on the basis of Fromm and Boezzart scale. Spearman rank correlation coefficient was used to assess the statistical dependence between the variables.Results: The best operative conditions were achieved in patients with the lowest MAP and HR. By keeping the HR at the level of 60 b/min in about 40% of patients very good and good operative field conditions were achieved at MAP higher than 65 mm Hg. There was a significant and strong correlation between the operative field conditions and MAP (Spearman rank correlation test, R = 0.54 p = 0.003).Conclusions: With the stable low heart rate at the minimal physiological values the bleeding in the operative field depends on MAP. Keeping HR around 60 b/min there is no need to decrease the MAP to dangerously low levels to achieve good operative field conditions in great proportion of patients.
Authors and Affiliations
Andrzej Sieśkiewicz, Marek Rogowski
Keywords
Related Articles
- EP ID EP51954
- DOI -
- Views 96
- Downloads 0
Analiza morfologii potencjałów słuchowych z pnia mózgu u pacjentów z samoistnym obwodowym porażeniem nerwu twarzowego
Introduction: Idiopathic facial nerve paresis still remains a challenge for laryngologists and neurologists. The etiology of idiopathic peripheral facial nerve paresis has not been explained so far. There is a group of p...
Epidural abscess as a complication of acute mastoiditis in a 7-year-old child
SUMMARY Introduction: Epidural abscess is the commonest intracranial complication of acute mastoiditis. In some cases this entity may pose a diagnostic problem. Materials and methods: We report a case of acute mastoiditi...
Problematyka zakażeń grzybiczych w obrębie zatok przynosowych
Fungal infections of the ear and paranasal sinus, are recognised quite rarely, but they make sometimes, for many reasons, very important diagnostic-therapy issue. Cantagion may developes near every paranasal sinus. Facil...
Ocena zaburzeń krzepnięcia u dzieci zakwalifikowanych do adeno/tonsilektomii
Introduction. The routine pre-operative evaluation of children undergoing elective tonsillectomy and/or adenoidectomy includes coagulation screening tests. The purpose of the study: detection of coagulation defects in ch...
An infl uence of myofascial release techniques on the esophagus pressure for patients after total laryngectomy
The increase of patients after total laryngectomy myofascial neck and arms area tension might be observed. Via fascial continuity it has an adverse impact on superior oesophageal constrictor, forming the “mouth of oesoph...