Evaluation of the Surgical Field in Functional Endoscopic Sinus Surgery: A Comparative Study of Propofol versus Sevoflurane Anaesthesia

Background and Aims: Hypotensive anaesthesia, to provide a bloodless field plays a very important role in the success of FESS. Among several agents, Sevoflurane and Propofol have been commonly used for the purpose globally.

Objectives: This study was done to compare the overall efficacy of Sevoflurane and Propofol as an agent for hypotensive anaesthesia in FESS.

Materials and Methods: Hundred patients, between 16-50 years, of either sex, belonging to ASA physical Status I or II, having Mallampatti Score 1 or 2 and posted for endoscopic sinus surgery were equally divided into two groups. After giving general anaesthesia with endotracheal intubation, patients in Group P received Infusion Propofol, starting at 12 mg/kg/hr for 10 minutes followed by 10mg/kg/hr for the next 10 minutes and then continued at 8 mg/kg/hr, whereas those in Group S received Sevoflurane at a dial concentration of 2%. Both the groups aimed a target MAP as 65 – 75mmHg. Intraoperative haemodynamics were assessed every 5 minutes, whereas quality of surgical field and Surgeon's satisfaction was checked at 30 and 60 minutes. The amount of intraoperative blood loss and postoperative sedation, nausea, vomiting, bradycardia and hypotension were taken into consideration.

Results: Patients receiving Propofol maintained a better haemodynamic profile, with low blood pressure and heart rate all throughout the procedure. Amount of intraoperative blood loss was also less with a better quality of surgical field and surgeon’s satisfaction score in the same group as compared to those receiving Sevoflurane.

Conclusion: Propofol is overall more efficacious than Sevoflurane to achieve hypotensive anaesthesia during Functional endoscopic sinus surgery (FESS).