xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

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Deliberate hypotension with TIVA may improve visualization. Operative time and EBL was not different. All low quality evidence.

TIVA improves visualization and reduces EBL

Kelly 1836 2012 1 Systematic review of RCTs 7 studies qualitatively reviewed No meta-analysis Mixed results with severe limitations instudies Little 1837 2018 2 RCT, double-blind IA(n = 15) TIVA(n = 15) TIVA improves visualization

TABLE XII-1 Evidence for anesthesia technique in sinus surgery Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Kolia 1834 2019 1 Systematic review of RCTs IA(n = 267) TIVA(n = 263) Surgical visualization EBL Operative time TIVA improves visualization as well as reduces EBL and operative time Boonmak 1829 2016 1 Systematic review of RCTs 1) Visualization (n = 277): a) IA(n = 140) b)TIVA(n = 137) 2) Operative Time (n = 214): a) IA(n = 111) b)TIVA(n = 103) EBL Surgical visualization Operative time IA(n = 269)

TIVA may improve surgical field, but this is based on low quality studies

No significant difference in operative time, EBL or surgeon rating. IA had higher anesthesiologist scores indicating easier management

Failure of deliberate hypotension Mortality within 24 hours Heart rate

Surgical visualization (Wormald) EBL Operative time Time in PACU Time to discharge Surgeon rating

Mean arterial pressure Anesthesia time Operative time EBL

Surgical visualization

Surgical visualization (Wormald) Surgical visualization (Boezaart) EBL Operative time Time to extubation EBL

Anesthesiologist rating Operative time

Brunner 1838 2018 2 RCT, double-blind IA(n = 33) TIVA(n = 37)

TIVA(n = 249)

Chaaban 1839 2013 2 RCT, double- blind IA (n = 15) TIVA(n = 18)

DeConde 1835 2013 1 Systematic review of RCTs