H S El-Ozairy, M R Naguib, A M Abd-Elmaksoud, O M Mady
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引用次数: 0
Abstract
Purpose: Middle ear surgeries are better executed under controlled hypotension. Reverse-Trendelenburg (RTP) position has been used in endoscopic sinus surgeries as a safe and cost-free method to reduce intraoperative bleeding. However, it has not been tried in ear surgery due to surgical field accessibility concerns. The primary aim of this study was to evaluate the effect of two RTP angles (10 and 20 degrees) on quality of surgical field and surgical position accessibility.
Methods: In total, 225 adult patients of both sexes, aged between 18 and 50years, ASA I-II, scheduled for elective middle ear surgery were enrolled in this randomized, prospective, controlled study. All patients were anesthetized using the same protocol. Patients were randomly and evenly allocated to one of three groups, 75 patients each; group I (control) patients were positioned supine, group II patients were positioned 10̊ RTP position and group III patients were positioned 20̊ RTP position. The surgeons were asked to assess the surgical field using a 5-point scale. The surgeon satisfaction concerning surgical position accessibility was evaluated using a 5-point scale. Total dexmedetomidine consumption, recovery time, surgical time and analgesia time were recorded.
Results: The quality of surgical field was significantly different among the three groups (P-value<0.001), being best in group III. Surgeon's satisfaction score was found to be statistically insignificant among the three study groups (P-value=0.251).
Conclusion: This study showed that 10 and 20-degree RTP provided a significantly better surgical field quality without considerably affecting accessibility and decreased intraoperative dexmedetomidine consumption shortening the recovery time.
期刊介绍：
European Annals of Oto-rhino-laryngology, Head and Neck diseases heir of one of the oldest otorhinolaryngology journals in Europe is the official organ of the French Society of Otorhinolaryngology (SFORL) and the the International Francophone Society of Otorhinolaryngology (SIFORL). Today six annual issues provide original peer reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches and review articles giving most up-to-date insights in all areas of otology, laryngology rhinology, head and neck surgery. The European Annals also publish the SFORL guidelines and recommendations.The journal is a unique two-armed publication: the European Annals (ANORL) is an English language well referenced online journal (e-only) whereas the Annales Françaises d’ORL (AFORL), mail-order paper and online edition in French language are aimed at the French-speaking community. French language teams must submit their articles in French to the AFORL site.
Federating journal in its field, the European Annals has an Editorial board of experts with international reputation that allow to make an important contribution to communication on new research data and clinical practice by publishing high-quality articles.
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