Evaluating the Role of Anesthesia on Intraoperative Blood Loss and Visibility during Endoscopic Sinus Surgery: A Meta-analysis

Background Previous studies and meta analyses have led to incongruent incomplete results respectively when total intravenous anesthesia (TIVA) inhalational (IA) are compared in endoscopic sinus surgeries regards intraoperative bleeding visibility. Objective To perform a more comprehensive meta-analysis on randomized controlled trial (RCTs) comparing TIVA with IA surgery evaluate their effects Methods A systematic review of for chronic rhinosinusitis was completed May 2020. Utilizing databases, articles were systematically screened analysis 19 met our inclusion criteria. The primary outcome included visibility scores combining Boezaart, Wormald Visual Analogue Scale (VAS). Secondary outcomes rate blood loss (mL/kg/min), estimated (mL), scores, VAS, heart rate, mean arterial pressure (MAP). Results RCTs 1,010 patients analyzed. had significantly lower score indicating better (Boezaart, Wormald) than (−0.514, p = 0.020). higher average by 0.563 mL/kg/min (p 0.016). Estimated (−0.853 mL, 0.002). There no significant differences between the (−0.225, 0.63) MAP values (−0.126, 0.634). subgroup revealed difference remifentanil not utilized whenever desflurane agent. Conclusion seemed superior during IA. However, consistent stratifying based use different inhaled anesthetics. Therefore, conclusion cannot be made that one approach is other.