Patients with CRS (as defined by EPOS Guidelines 2012) with or without nasal polyposis whom FESS is indicated due to refractory to adequate medical treatment.Surgical procedure must include complete l reverse Trendelenburg position endoscopic sinus surgery intraoperative blood loss surgical position cerebral oximetry
Conditions
Interventions
40 degree reverse Trendelenburg position
head up foot down measure with magnetic protractor during endoscopic sinus surgery,20 degree reverse Trendelenburg position
head up foot down measure with magn
Experimental Procedure/Surgery,Active Comparator Procedure/Surgery
40 degree reverse Trendelenburg position,20 degree reverse Trendelenburg position
Sponsors
Department of Otolaryngology King Chulalongkorn memorial hospital
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1. Patients with CRS (as defined by EPOS Guidelines 2012) with or without nasal polyposis whom FESS is indicated due to refractory to adequate medical treatment. Surgical procedure must include complete large maxillary antrotomy, total ethmoidectomy, wide sphenoidotomy, Draf IIA frontal sinusotomy 2. Patients aged 18 years old and above 3. Patients with American Society of Anesthesiologist(ASA) physical status classification score of less than III
Exclusion criteria
Exclusion criteria: 1. ischemic heart disease, severe or uncontrolled hypertension, Severe renal impairment (GFR<60) diabetes mellitus cerebrovascular disease, brain tumor 2. Coagulopathy, platelet below 50,000 or PT,APTT more than 1.5 times normal or INR more than 1.5 3. Intranasal or sinus tumor or vascular anomalies 4. antiplatelet, anticoagulant, herbal use, Vitamin supplement that will effect hemostasis 5. Patient who is planned to undergo other precedures in the same surgery 6. Allergic to any medications used in this study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total blood loss during endoscopic sinus surgery during entire operative period Record as ml(measure from suction fluid and irrigated fluid),Blood loss per minute during endoscopic sinus surgery during entire operative period calculated as ml/min from total blood loss devide by total operative time | — |
Secondary
| Measure | Time frame |
|---|---|
| Cerebral desaturation during entire operative period Cerebral oximetry,Skull base complication during entire operative period observe event,Venous air embolism during entire operative period observe event | — |
Countries
Thailand
Contacts
Public ContactPeerada Arreenich
department of otolaryngology King chulalongkorn memorial hospital
Outcome results
None listed