Abstract

Background and Aim: Functional endoscopic sinus surgery (FESS) is a procedure for surgical treatment for patients with chronic sinusitis and chronic polypus rhinosinusitis. Both the bloodless surgical field and surgical field clarity are required during the procedure. We aimed to study whether the RAMPED positioning could reduce blood loss and improve surgical field clarity during FESS.

Methods: A number of 50 patients with chronic rhinosinusitis (CRS) with and without nasal polyposis of American Society of Anaesthesiologists (ASA) grade I/II, scheduled for FESS were included in the study. They were blindly selected and randomized into two groups, 25 in each, SG (Supine Group) and RG (RAMPED Group). The total blood loss, intraoperative haemodynamic stability, surgical field clarity, consumption of sevoflurane and remifentanil, and total surgical time were assessed and compared between the two groups. Fischer test and student t. test were used to analyze the demographic and continuous variables respectively.

Results: The estimated blood loss in RG was 256.4 ± 96.8 ml as compared to to314.7 ± 107.3 ml in SG (P-value 0.0493). Better Fromme-Boezaart scoring system (FBS) for the surgical field was recorded in RG as compared to SG (1.67 ± 0.52 in RG versus 2.46 ± 0.73 in SG) (P value ≤ 0.000).

Conclusion: Our study concluded that the use of RAMPED position during FESS is associated with improvement in the surgical field, a decrease in blood loss and short operative time compared to the supine position.

Keywords: Functional Endoscopic Sinus Surgery; FESS; Supine; RAMPED; Rhinosinusitis; Sinusitis

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