Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial

Hua Shao, Li-Ting Kuang, Wei-Jian Hou, Tao Zhang, Hua Shao, Li-Ting Kuang, Wei-Jian Hou, Tao Zhang

Abstract

Background: Bleeding during functional endoscopic sinus surgery is a challenge for the quality of the surgical field for surgeons. This study aimed to evaluate the effect of desmopressin premedication on blood loss and the quality of the surgical field in endoscopic sinus surgery.

Methods: A total of 90 American Society of Anesthesiologists physical status I-II patients underwent endoscopic sinus surgery for chronic sinusitis. They were randomly allocated to receive either desmopressin 0.3 μg/kg or saline before the operation. Management of anesthesia was achieved with propofol and remifentanil infusions, with moderate, controlled hypotension. Blood loss and quality of the surgical field were assessed after surgery. Effects of desmopressin on anesthetic requirements and hemodynamic variables were analyzed.

Results: Blood loss was significantly less in the desmopressin group (mean ± SD, 42 ± 8.7 ml) than in the control group (70 ± 9.2 ml, P < 0.001). Surgeons were more satisfied with the surgical field in the desmopressin group than in the control group (median score, 4 [3-5] vs. 7 [6-9], P < 0.001). Requirements for remifentanil and esmolol were lower in the desmopressin group than in the control group.

Conclusions: Premedication with desmopressin 0.3 μg/kg can effectively reduce bleeding during endoscopic sinus surgery.

Figures

Figure 1
Figure 1
Flow chart. The chart shows that 116 patients were initially screened for the study and finally 90 patients were included in the data analysis.
Figure 2
Figure 2
Mean arterial blood pressure values in each of the groups over the course of surgery. The symbols show mean values. Data are presented at 10-min intervals, up to 80 min. The “0” and “End” values refer to the start and end of surgery, respectively. *P < 0.05 compared with the control group.
Figure 3
Figure 3
Heart rate in each of the groups over the course of surgery. The symbols show mean values. Data are presented at 10-min intervals, up to 100 min. The “0” and “End” values refer to the start and end of surgery, respectively. *P < 0.05 compared with the control group.

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