Background: It is crucial to reduce bleeding during functional endoscopic sinus surgery (FESS). Our primary goal was to evaluate the effect of intravenous lidocaine infusion (ILI) as an adjunct to the enhanced recovery after surgery (ERAS) protocols on intraoperative bleeding during FESS. We hypothesized that ILI could improve the surgical field.
Methods: Forty-three adult patients ASA I-II, 20-50 years old, undergoing FESS under general anesthesia were randomly assigned to receive immediately after induction of anesthesia either ILI 1.5 mg/kg as a bolus followed by 1.5 mg/kg/ h until the end of surgery (Group L) or normal saline (Group NL). Intraoperative blood loss, bleeding and surgeon satisfaction scores, mean arterial pressure (MAP), heart rate (HR), extubation and eye-opening times, and time to first analgesic request were recorded.
Results: Intraoperative bleeding and bleeding scores in the first 45 min after ILI were decreased, with better surgeon satisfaction in Group L (P<0.05). MAP and HR values were lower after ILI in Group L during surgery (P<0.05). Extubation and eye-opening times were shorter (P=0.001) and the time to first analgesic request was prolonged (P=0.001) in Group L than in Group NL.
Conclusions: ILI decreased intraoperative blood loss and improved the surgical field visibility in the first 45 min during FESS.