Desmopressin effects on bleeding during functional endoscopic sinus surgery on patients with chronic rhinosinusitis

Hajimohamadi, Fatemeh; Hosseini, Jawad; Heidari, Farrokh; Alvandi, Sepideh; Bastaninezhad, Shahin; Ghabasiah, AmirHossein; Tajdini, Ardavan

doi:10.1016/j.amjoto.2021.103024

Cited by 7 publications

(18 citation statements)

References 14 publications

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“…were included in this systematic review and meta-analysis. 5,6,[13][14][15] All included patients had no history of bleeding disorders, anticoagulant therapy, poorly controlled hypertension, cerebrovascular disease, arrhythmias, or compromised renal/hepatic function. For all patients, FESS was performed for chronic rhinosinusitis.…”

Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

“…27 In the present investigation, all the meta-analysed studies assessed the amount of estimated intraoperative blood loss via the gravimetric approach (i.e., measuring blood loss in section cylinders and weighing the used sponges). 5,6,[13][14][15] Although the gravimetric approach is less accurate; nevertheless, it is commonly used and is technically recognised as the most reliable and practical approach. 27 Several clinical and surgical parameters have been identified that will negatively impact the magnitude of intraoperative blood loss during FESS.…”

Section: Interpretation Of Findings and Clinical Implicationsmentioning

confidence: 99%

“…12 Several randomised placebo-controlled trials (RCTs) have examined the clinical effectiveness and safety of DDAVP as a haemostatic agent during FESS. 5,6,[13][14][15] Nonetheless, the results have been limited by conflicting findings, small sample size of patients, and different routes of DDAVP administration. To our understanding, no meta-analysis up to now has been carried out to systematically aggregate evidence on the topic.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of prophylactic pre‐operative desmopressin administration during functional endoscopic sinus surgery for chronic rhinosinusitis: A systematic review and meta‐analysis of randomised placebo‐controlled trials

Alrajhi

Alghamdi

Baali³

et al. 2023

Clinical Otolaryngology

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Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

Section: Interpretation Of Findings and Clinical Implicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of prophylactic pre‐operative desmopressin administration during functional endoscopic sinus surgery for chronic rhinosinusitis: A systematic review and meta‐analysis of randomised placebo‐controlled trials

Alrajhi

Alghamdi

Baali³

et al. 2023

Clinical Otolaryngology

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“…Nonetheless, there are several concerns regarding the methodology of these studies 11 . Two other RCTs also evaluated the effects of intravenous desmopressin on bleeding and quality of the surgical field 12,13 . The effect of intranasal (local) desmopressin administration on intraoperative blood loss in endoscopic sinus surgery is therefore limited.…”

Section: Introductionmentioning

confidence: 99%

“… 11 Two other RCTs also evaluated the effects of intravenous desmopressin on bleeding and quality of the surgical field. 12 , 13 The effect of intranasal (local) desmopressin administration on intraoperative blood loss in endoscopic sinus surgery is therefore limited. The primary outcomes of the present study were to determine the effect of the administration of different doses (minimum and maximum) of intranasal desmopressin on intraoperative blood loss and the quality of surgical field in patients undergoing endoscopic sinus surgery.…”

Section: Introductionmentioning

confidence: 99%

Effect of desmopressin on bleeding during endoscopic sinus surgery: A randomized clinical trial

Akbarpour

Jalali

Akbari

et al. 2022

Laryngoscope Investig Oto

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Background This study aimed to evaluate the effect of local nasal desmopressin premedication on blood loss and the quality of surgical field in Functional Endoscopic Sinus Surgery (FESS). Material and methods In a randomized clinical trial, patients referred for FESS to treat their bilateral chronic rhinosinusitis were recruited. The participants were adults (≥18 years). They were randomly assigned (1:1:1) to receive low‐dose (20 μg) or high‐dose (40 μg) intranasal desmopressin (DDAVP) or placebo 60 min before the induction of general anesthesia. Standard FESS was performed by the same surgeon. The primary outcomes were volume of intraoperative bleeding and the quality of surgical field. Clean surgical field was defined as a score ≤2 on the Boezaart grading system. Results A total of 120 patients were included on an intention‐to‐treat basis (mean age: 41.0 years; 40 women, 80 men). There were no significant differences in primary outcomes between low‐dose DDAVP and placebo. As for the volume of blood loss, however, there was a significant difference between high‐dose DDAVP and placebo (mean difference: 29.6 ml; adjusted Cohen's d: −1.02; p < .001). Also, in the high‐dose DDAVP, the probability of having a good surgical field over time was about two times higher than in the placebo group (RRs for first and second surgical sides: 1.89 and 2.18). The number needed to treat for the two time points was 1.6 and 1.3, respectively. Conclusion The present study showed that the use of desmopressin at a dose of 40 μg 1 h before surgery can reduce bleeding and improve the quality of the surgical field. Further studies are recommended to be able to generalize these findings to other ENT surgeries. Level of evidence 1b.

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Intraoperative Bleeding Control with Terlipressin in Functional Endoscopic Sinus Surgery

et al. 2023

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ObjectiveTo evaluate the use of terlipressin for intraoperative bleeding reduction in functional endoscopic sinus surgery (FESS).MethodsThis prospective, randomized, single‐center, single‐blinded cohort study included 74 cases of FESS performed under general anesthesia (GA). The patients were randomized into two groups: WT (without terlipressin, n = 39) and T (with 200 μg terlipressin, n = 35). Bleeding intensity (BI) was assessed using a 6‐point scale. Heart rate (HR), mean blood pressure (MBP), perfusion index (PI), and BI were recorded at 10, 30, and 60 min after surgery. A BI score ≥2 qualified as significant.ResultsThe T group had significantly higher MBP compared with the WT group, but HR values did not differ significantly. PI and BI scores were significantly reduced in the T group compared with the WT group. The risk of significant bleeding in the treatment group was 35.5 times lower (odds ratio [OR], 0.028; 95% confidence interval [CI], 0.006–0.138) at 30 min and 7.1 times lower (OR, 0.140; 95% CI, 0.049–0.402) at 60 min. The prognostic model for significant bleeding at 60 min showed that only terlipressin played a significant role in bleeding control (p < 0.05). The model predicted a 13.9‐fold decrease in significant bleeding risk in the T group.ConclusionLow doses (200 μg) of terlipressin reduced intraoperative bleeding without decreasing blood pressure during FESS under GA.Level of Evidence2 Laryngoscope, 2023

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Desmopressin effects on bleeding during functional endoscopic sinus surgery on patients with chronic rhinosinusitis

Cited by 7 publications

References 14 publications

Efficacy of prophylactic pre‐operative desmopressin administration during functional endoscopic sinus surgery for chronic rhinosinusitis: A systematic review and meta‐analysis of randomised placebo‐controlled trials

Efficacy of prophylactic pre‐operative desmopressin administration during functional endoscopic sinus surgery for chronic rhinosinusitis: A systematic review and meta‐analysis of randomised placebo‐controlled trials

Effect of desmopressin on bleeding during endoscopic sinus surgery: A randomized clinical trial

Intraoperative Bleeding Control with Terlipressin in Functional Endoscopic Sinus Surgery

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