The effect of hypotensive anaesthesia on cognitive functions and recovery at endoscopic sinus surgery

Risks and benefits of deliberate hypotension in anaesthesia: a systematic review

“…Three studies did not include a normotensive group 26,41,197 and thus the potential benefits of hypotensive anaesthesia over normotensive anaesthesia were not investigated. Out of the remaining five studies, only three showed significant decrease in blood loss 81,102,153 . Two studies compared the transfusion rate of the study groups and both showed a significant decrease in transfusion rate in the hypotensive group compared to the normotensive group 81,102 .…”

“…Two studies reported improvement of the surgical field and reduced operation time following the use of hypotensive anaesthesia 45, 102 . Two studies failed to demonstrate a significant difference in operation time between the hypotensive and normotensive groups 81,153,197 . Patient selection was not consecutive and complete 2 Did not describe method of randomization * 1 = low risk of bias; 2 = moderate risk of bias; 3 = high risk of bias.…”

“…Fifty-seven articles were found relevant to this topic: 14 randomized clinical trials 6,10,47,49,50,52,60, 69,72,83,153,179,180,197 , 4 controlled clinical trials 2,110,184,186 , 1 case-controlled study 105 181,190,193,194,199 , 3 retrospective case series 28,127,189 and 2 case reports 68,96 .…”

“…Since then, various techniques for inducing hypotension during surgery have been used in orthopaedic and neurosurgical procedures, and the technique was first used in oral and maxillofacial surgery by SCHABERG et al in 1976 155 . Although hypotensive anaesthesia has been shown to reduce intraoperative blood loss 40,102,[135][136][137]152,153,155,169,176,180,201 , studies performed to evaluate its efficacy in reducing blood loss in orthognathic surgery produced conflicting results 53,61,62 . A risk of hypoperfusion of vital organs during deliberate hypotension has been demonstrated in other studies 20,52,118,127,138,204 .…”

A role of anesthesiologist in reducing surgical bleeding in endoscopic sinus surgery

“…The only serious limitation during general anesthesia is that bleeding is more intensive than during local anesthesia (1,2). Surgical bleeding decreases visibility of the surgical fi eld during an intervention and appears to be one of the most serious problems of FESS (2)(3)(4). Reduced visibility of the surgical fi eld is related to an increased risk of dangerous vascular, orbital, and intracranial complications, prolonged duration of intervention, and reduced quality of intervention (1,5,6).…”