ArticleAnnals of medicine2026
Warm intranasal saline irrigation reduces intraoperative blood loss during functional endoscopic sinus surgery: a propensity score-matched cohort study.
Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate whether warm intranasal saline irrigation (38-40 °C) during functional endoscopic sinus surgery (FESS) is associated with reduced intraoperative bleeding compared with standard cold irrigation (18-21 °C).
methodsWe performed a single-centre retrospective cohort study of consecutive FESS procedures under inhalational general anaesthesia (January 2017-December 2022). After exclusions, 1,990 cases were eligible. One-to-one propensity score matching (age, sex, ASA class, and type of inhaled anaesthetic) yielded 409 warm and 409 cold cases. Primary outcomes were estimated blood loss and blood loss >50 mL. Secondary outcomes included anaesthesia duration, intraoperative medication requirements, and lowest recorded temperature. Multivariable logistic regression adjusted for BIS monitoring utilisation, intravenous fluid rate, and intraoperative antihypertensive medication use.
resultsMedian blood loss was 50 mL (IQR 50-50) with warm irrigation versus 50 mL (IQR 50-100) with cold irrigation (
conclusionsWarm intranasal saline irrigation at 38-40 °C was associated with fewer clinically significant bleeding events during routine FESS and may represent a simple, low-cost adjunct to perioperative haemostatic management.
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