Trial reportInternational forum of allergy & rhinology2018
Total intravenous anesthesia improves intraoperative visualization during surgery for high-grade chronic rhinosinusitis: a double-blind randomized controlled trial.
Trial report in International forum of allergy & rhinology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 47 citations in OpenAlex.
- Does preoperative administration of hypotensive agents affect the quality of the surgical field during endoscopic sinus surgery? A triple-blind randomized controlled trial.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Trial
- Randomized comparison of effects of two different remifentanil dose on surgical conditions during endoscopic sinus surgery.BMC anesthesiology · 2023Trial
- Inhalational Anesthesia is Noninferior to Total Intravenous Anesthesia in Terms of Surgical Field Visibility in Endoscopic Sinus Surgery: A Randomized, Double-Blind Study.Drug design, development and therapy · 2023Trial
- Enhanced recovery after endoscopic sinus surgery: Establishing comprehensive protocols for improvement of perioperative patient care.World journal of otorhinolaryngology - head and neck surgery · 2025Review
- Cost-utility and clinical outcome analysis of surgery or oral corticosteroids treatment in patients with chronic rhinosinusitis with nasal polyps.Asia Pacific allergy · 2024Article
- Article
- Effect of Anesthesia on Endoscopic Sinus Surgery Hemostasis: A State-of-the-Art Review.Cureus · 2023Review
- Tranexamic acid for the reduction of bleeding during functional endoscopic sinus surgery.The Cochrane database of systematic reviews · 2023Review
- Anaesthesia for rhinological surgery.BJA education · 2021Review
- The Choice of Anesthetic Agents for Endoscopic Sinus Surgery: Can Sinus Surgeons Be Involved?Clinical and experimental otorhinolaryngology · 2021Article
- Intravenous Tranexamic Acid Improves the Intraoperative Visualization of Endoscopic Sinus Surgery for High-Grade Chronic Rhinosinusitis: A Randomized, Controlled, Double-Blinded Prospective Trial.Frontiers in surgery · 2021Article
- Article
- Perioperative management of endoscopic transsphenoidal pituitary surgery.World journal of otorhinolaryngology - head and neck surgery · 2020Review
- Optimization of the Surgical Field in Endoscopic Sinus Surgery: an Evidence-Based Approach.Current allergy and asthma reports · 2019Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundTotal intravenous anesthesia (TIVA) has been proposed as a method to reduce blood loss during endoscopic sinus surgery (ESS). Impaired sinonasal visualization due to mucosal bleeding may be burdensome in cases of chronic rhinosinusitis (CRS) with high-grade inflammatory disease, suggesting a role for TIVA in that disease subgroup.
methodsA double-blind, randomized controlled trial was conducted of adults undergoing ESS at a tertiary medical center. Patients considered for inclusion had high-grade CRS defined as either sinonasal polyposis or a preoperative Lund-Mackay score of ≥12. Subjects were randomized to receive either TIVA or inhaled anesthesia (IA) during ESS. The primary outcome measure was intraoperative visibility as rated by 3 blinded reviewers utilizing the 10-point Wormald Surgical Field Grading Scale. Secondary outcomes included operative blood loss, complications, and change in quality of life evaluated by the 22-item Sino-Nasal Outcome Test (SNOT-22).
resultsA total of 72 patients were randomized into TIVA (n = 37) and IA (n = 35) study arms. Aggregate median (interquartile range) Wormald scores across all reviewers demonstrated a more favorable visual field with TIVA compared to IA (3.5 [2.4-3.9] vs IA 4.1[3.0-5.8], p = 0.0089). There was significantly less blood loss in the TIVA group compared to the IA group (200 mL [100-450] vs 300 mL [200-500], p = 0.046). Baseline patient characteristics were comparable between cohorts with no significant postoperative complications. No significant changes were detected between postoperative SNOT-22 scores at 3 months (p = 0.278) and at 6 months (p = 0.396) following ESS.
conclusionTIVA contributes to improved intraoperative visualization and decreased blood loss in patients undergoing ESS for high-grade inflammatory sinus disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.