Možnosti a riziká anestéziepri endoskopickej endonazálnej chirurgii

Possibilities and Risks of Anaesthesia in Endoscopic EndonasalSurgery

The authors present the results of a retrospective study involving the application,results and complications of general anaesthesia during endoscopic endonasal surgery. They review582 unilateral endoscopic endonasal operations in 299 patients during nine years from January 1991till December 1999 at the ENT department in Žilina. A total of 321 general anaesthesias wereadministered. Most frequently neuroleptoanaesthesia was administered - in 74 %. General intravenous anaesthesia was used in 15 % and combined intravenous anaesthesia in 11 %. The meanduration of the operation and mean length of anaesthesia was 72 minutes/86 minutes in unilateraloperations and 115 minutes/129 minutes in bilateral operations. The mean time for the anaesthesiologist was 14 minutes. No significant differences were found between different types of anaesthesia.The mean value of the peroperative blood loss was 80 ml in unilateral operations and 170 ml inbilateral operations. Seven major complications were recorded - five times peroperative haemorrhage calling for a blood transfuson, once liquorrhoea and one death, with an incidence of 2.3% inrelation to the number of patients and 1.2% in relation to the number of operations. The majority ofmajor complications occurred in the group with neuroleptoanaesthesia which was however usedmost frequently - five times. The authors compare their experience with data in the literature andconsider general anaesthesia in endoscopic endonasal surgery a safe method provided other factorsare met - careful preoperative preparation, detailed knowledge of anatomy and surgical techniqueand close cooperation between the ENT specialist and anaesthesiologist.

Key words:
endoscopic endonasal surgery, general anaesthesia, local anaesthesia, complications, haemorrhage.