Abstract
Objective: 1) To determine whether the 15-degree reverse Trendelenburg position (RTP) during FESS improves endoscopic field of view compared to the horizontal position (HP). 2) To determine whether the 15-degree RTP during FESS reduces intraoperative blood loss compared to the HP.
Method: Fifty CRS patients undergoing FESS were randomized to either 15-degree RTP (experimental arm) or HP (control arm) from October 2011 to February 2012. Boezaart endoscopic field of view grading system was the primary outcome measure. Total blood loss, blood loss/minute, MAP, heart rate, anesthetic technique, and surgery time were recorded.
Results: The 43 patients currently studied show a significant difference in mean Boezaart scoring between RTP and HP: 1.698 vs 2.124 (P = .009), with RTP producing a better endoscopic field of view. There was also less blood loss per minute with RTP (P = .05). No significant difference was found in total blood loss (P = .236), time of surgery (P = .458), or mean arterial pressure (P = .825) between the 2 surgical positions.
Conclusion: The 15-degree RTP improves the endoscopic field of view during FESS and also reduces blood loss per minute during surgery. We would therefore recommend its use.
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