标题：Surgeon Satisfaction During Endoscopic Management of Cerebrospinal Fluid Rhinorrhea: A Comparison Between Propofol-Remifentanil and Isoflurane-Remifentanil Anesthesia
期刊名称：Journal of Minimally Invasive Surgical Sciences
印刷版ISSN：2251-7022
电子版ISSN：2251-7030
出版年度：2012
卷号：1
期号：2
页码：62-66
DOI：10.5812/jmiss.1839
出版社：Kowsar
摘要：Background: Surgeons depend to a large degree on the amount of blood loss and a clear view of the surgical field, when conducting endoscopic procedures in order to achieve satisfactory outcomes. The anesthesiologists choice of method for the induction and maintenance of anesthesia plays a major role in achieving this goal. Objectives: This study was performed in order to compare the two most well-known methods in this regard; total intravenous anesthesia (TIVA) and venous inhalational mixed anesthesia (VIMA). Patients and Methods: This study included the endoscopic management of 89 patients with cerebrospinal leakage (CSF leakage) covering a period of nine years (1999-2008) for whom a subarachnoid injection of fluorescein was first administered, and afterwards they were maintained under general anesthesia using two distinct methods; propofol-remifentanil versus isofluraneremifentanil (inhalational or intravenous). During the operation, hemodynamic indices, blood loss, and surgeons satisfaction, were assessed and compared between the two groups. Results: Endoscopic management and autografts were successful in repairing anterior skull defects in 90% of cases. Regarding the surgeons satisfaction level, and hemodynamic stability no significant difference between the two groups was observed (P > 0.01). Conclusions: Both isoflurane and propofol in combination with remifentanil afford optimal surgical conditions with regard to hemodynamic parameters and the satisfaction of the surgeon with the surgical field.
