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. 2014 Jan;30(1):59-64.
doi: 10.4103/0970-9185.125705.

Oral bisoprolol improves surgical field during functional endoscopic sinus surgery

Sumitha Mary Jacob  1 , Tony Thomson Chandy  2 , Verghese T Cherian  3
Affiliations

Oral bisoprolol improves surgical field during functional endoscopic sinus surgery

Sumitha Mary Jacob et al. J Anaesthesiol Clin Pharmacol. 2014 Jan.

Abstract

Background: The success of functional endoscopic sinus surgery (FESS) depends on visual clarity of the surgical field, through the endoscope. The objective of this double-blind, randomized, controlled study was to determine if a pre-operative dose of bisoprolol (2.5 mg) would reduce the bleeding during FESS and improve the visualization of the operative field.

Materials and methods: Thirty American Society of Anesthesiologists I or II patients, scheduled for FESS were randomized to receive either a placebo (Group A) or 2.5 mg of bisoprolol (Group B) 90 min prior to the surgery. All the patients received standard anesthesia and monitoring. The aim was to maintain the mean arterial pressure (MAP) of 60-70 mmHg, by titrating dose of isoflurane and fentanyl. The concentration of isoflurane used was recorded every 15 min. At the end of the surgery, the volume of blood loss was measured and the surgeon was asked to grade the operative field as per the Fromme-Boezaart Scale.

Result: The blood loss was significantly (P < 0.0001) more in the control group (398.67 ± 228.79 ml) as compared with that in the bisoprolol group (110.67 ± 45.35 ml). The surgical field was graded better in those who received bisoprolol as compared with those in the control group (P - 0.0001). The volume percent of isoflurane and the dose of fentanyl used was significantly lower in those who received bisoprolol. During the operative period, the MAPs were 70.0 ± 2.7 (Group A) and 62.6 ± 3.6 mmHg (Group B) and the heart rate was 99.8 ± 5.0/min (Group A) and 69.2 ± 4.4/min (Group B). These differences were statistically significant ( P - 0.001).

Conclusion: This clinical trial has demonstrated that administration of a single pre-operative dose of bisoprolol (2.5 mg) can significantly reduce the blood loss during FESS and improve the visualization of the operating field.

Keywords: Beta-blocker; bisoprolol; blood loss; functional endoscopic sinus surgery; surgical field.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
The average heart rate was significantly lower in the “bisoprolol” group compared to the “control” group
Figure 2
Figure 2
The mean arterial pressure (MAP) tended to be higher in the “control” group despite efforts to maintain it between 60 and 70 mmHg. The average MAP in the “control” and the “bisoprolol” group, during the actual surgery time, was 70 ± 2.7 and 62 ± 3.6 mmHg respectively
See this image and copyright information in PMC

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