Pre-operative Oral Bisoprolol Improves the Surgical Field during Functional Endoscopic Sinus Surgery: A Randomized, Controlled, Prospective and Double-Blinded Study

  • P Sophia Assistant Professor, Department of Anaesthesiology and Critical Care
  • B Sowbhagya Lakshmi Professor and Head, Department of Anaesthesiology and Critical Care
  • P Krishna Prasad Associate Professor, Department of Anaesthesiology and Critical Care
  • K V Chandramouli Post Graduate student, Department of Anaesthesiology and Critical Care
Keywords: Adrenergic receptor antagonists, Bisoprolol fumarate, Fentanyl, Operative time


Background: Functional Endoscopic Sinus Surgery (FESS) is a surgical technique performed for indications such as chronic
sinusitis, a chronic polypous rhinosinusitis of the nasal mucosa, Hypotrophy of turbinates, etc. Bloodless and clear surgical fi eld
is very essential for the success of FESS and decreased operative times. The aim was to study the effects of oral bisoprolol,
a longer acting β - Blocker to reduce the blood loss and improve the visual clarity during FESS.
Methodology: In this randomized double-blind controlled study, 50 patients of ASA Class-I and Class-II who were candidates
for FESS were included in the study and divided into two groups. The following parameters were assessed and compared
between both the Groups (a) Intra-operative blood loss, (b) Surgical fi eld visual clarity, (c) Peri-operative Hemodynamics,
(d) Intra-operative requirement of sevofl urane and fentanyl, (e) Post-operative hemoglobin level. To grade the clarity of the surgical
fi eld, the surgeon was asked to assess operative fi eld condition according to the quality scale proposed by Fromme Boezaart.
Demographic variables were analyzed using Fischer’s Exact test continuous variables were analyzed using Student’s t-test.
Results: The mean estimated blood loss was signifi cantly more in the control Group A than Group B (425 ± 110.6 vs. 145 ± 34.6),
P = 0.0001. The grading of the operative fi eld by the surgeon according to Fromme-Boezaart grading scale was found to be
favorable in Bisoprolol group, P = 0.005.
Conclusion: Preoperative single dose of Bisoprolol fumarate 2.5 mg signifi cantly reduced the blood loss during surgery and
improved the visualization of the operating fi eld during FESS.

Author Biographies

P Sophia, Assistant Professor, Department of Anaesthesiology and Critical Care

Rangaraya Medical College, Kakinada, Andhra Pradesh, India

B Sowbhagya Lakshmi, Professor and Head, Department of Anaesthesiology and Critical Care

Rangaraya Medical College, Kakinada, Andhra Pradesh, India

P Krishna Prasad, Associate Professor, Department of Anaesthesiology and Critical Care

Rangaraya Medical College, Kakinada, Andhra Pradesh, India

K V Chandramouli, Post Graduate student, Department of Anaesthesiology and Critical Care

Rangaraya Medical College, Kakinada, Andhra Pradesh, India


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