The Effects of Hypocapnia and Hypercapnia on Intraoperative Bleeding, Surgical Field Quality, and Surgeon Satisfaction Level in Septorhinoplasty: A Prospective Randomized Clinical Study
Background Septorhinoplasty (SRP) is one of the most commonly performed procedures in the world for functional and aesthetic purposes. The present study was aimed to compare the effects of hypocapnia and hypercapnia regarding the total amount of intraoperative bleeding, surgical field quality, and s...
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| Veröffentlicht in: | Aesthetic plastic surgery 2024, Vol.48 (2), p.167-176 |
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| creator | Calim, Muhittin Karaaslan, Kazim Yilmaz, Sinan Senturk, Erol Deniz, Hilal Akbas, Sedat |
| description | Background
Septorhinoplasty (SRP) is one of the most commonly performed procedures in the world for functional and aesthetic purposes. The present study was aimed to compare the effects of hypocapnia and hypercapnia regarding the total amount of intraoperative bleeding, surgical field quality, and surgeon satisfaction level.
Methods
In this randomized prospective clinical study, eighty patients with American Society of Anesthesiologists I–II and were 18–45 years old scheduled for septorhinoplasty were randomly allocated to group hypocapnia [end-tidal carbon dioxide (EtCO
2
) 30 ± 2 mmHg] and group hypercapnia (EtCO
2
40 ± 2 mmHg). We evaluated the total amount of intraoperative bleeding, the surgical field quality, surgeon satisfaction level, hemodynamics and peri- and postoperative adverse events.
Results
Group hypocapnia significantly reduced the total amount of intraoperative bleeding (
p
|
| doi_str_mv | 10.1007/s00266-023-03433-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2833997423</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2833997423</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-671364627c673fdf2d7fee67f0ca528a81158c30ca8ad70a807eb4ca0529be5a3</originalsourceid><addsrcrecordid>eNp9UctuFDEQtBCILIEf4IAsceGQAT9mxjPcwiohkVbisUHiZnk97Y0jrz2xPZGWP-Pv8D4AiQMnq7qrqrtdCL2k5C0lRLxLhLC2rQjjFeE151X_CM1ozVnVsJo-RjPC27pitP1-gp6ldEcIZULUT9EJFzURgvQz9PPmFvCFMaBzwsHgq-0YtBq9VVj5YQchHnHw-NrnqEIpqWwfAH9wAIP16zO8nOLaauXwpQU34C-TcjZvz_Yeux4U8bKIklE62wIW8AAO21KFMYd4a30YnUp5-x6f488xpLFstJvxtViEjf0BA5476_dDlnkats_RE6NcghfH9xR9u7y4mV9Vi08fr-fni0pz1uaqFbT8QsuEbgU3g2GDMACtMESrhnWqo7TpNC-oU4MgqiMCVrVWpGH9ChrFT9Gbg-8Yw_0EKcuNTRqcUx7ClCTrOO97UTNeqK__od6FKfqynWQ9F7TuetIUFjuwdDkzRTByjHaj4lZSInfBykOwsgQr98HKvoheHa2n1QaGP5LfSRYCPxBSafk1xL-z_2P7CzePsRg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2937148905</pqid></control><display><type>article</type><title>The Effects of Hypocapnia and Hypercapnia on Intraoperative Bleeding, Surgical Field Quality, and Surgeon Satisfaction Level in Septorhinoplasty: A Prospective Randomized Clinical Study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Calim, Muhittin ; Karaaslan, Kazim ; Yilmaz, Sinan ; Senturk, Erol ; Deniz, Hilal ; Akbas, Sedat</creator><creatorcontrib>Calim, Muhittin ; Karaaslan, Kazim ; Yilmaz, Sinan ; Senturk, Erol ; Deniz, Hilal ; Akbas, Sedat</creatorcontrib><description>Background
Septorhinoplasty (SRP) is one of the most commonly performed procedures in the world for functional and aesthetic purposes. The present study was aimed to compare the effects of hypocapnia and hypercapnia regarding the total amount of intraoperative bleeding, surgical field quality, and surgeon satisfaction level.
Methods
In this randomized prospective clinical study, eighty patients with American Society of Anesthesiologists I–II and were 18–45 years old scheduled for septorhinoplasty were randomly allocated to group hypocapnia [end-tidal carbon dioxide (EtCO
2
) 30 ± 2 mmHg] and group hypercapnia (EtCO
2
40 ± 2 mmHg). We evaluated the total amount of intraoperative bleeding, the surgical field quality, surgeon satisfaction level, hemodynamics and peri- and postoperative adverse events.
Results
Group hypocapnia significantly reduced the total amount of intraoperative bleeding (
p
< 0.001). The surgical field quality and surgeon satisfaction level in group hypocapnia were significantly better than group hypercapnia (
p
< 0.001). EtCO
2
levels of group hypocapnia were significantly lower than group hypercapnia at all time points (
p
< 0.001 for all time points). There were no significant differences between the groups in terms of heart rate and mean arterial pressure at all time points. There were no significant differences between the groups in terms of adverse events
Conclusions
The results of this double-blind randomized clinical trial showed that reducing the amount of intraoperative bleeding for patients with hypocapnia undergoing SRP through known methods (e.g., reverse Trendelenburg head-up position, positive end-expiratory pressure limiting, controlled hypotension, and use of topical vasoconstrictors, corticosteroids, and tranexamic acid) would improve the quality of the surgical field and raise the surgeon satisfaction level.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.</description><identifier>ISSN: 0364-216X</identifier><identifier>EISSN: 1432-5241</identifier><identifier>DOI: 10.1007/s00266-023-03433-9</identifier><identifier>PMID: 37407709</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Hemorrhage ; Humans ; Hypercapnia ; Hypocapnia ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Otorhinolaryngology ; Plastic Surgery ; Prospective Studies ; Surgeons ; Young Adult</subject><ispartof>Aesthetic plastic surgery, 2024, Vol.48 (2), p.167-176</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-671364627c673fdf2d7fee67f0ca528a81158c30ca8ad70a807eb4ca0529be5a3</cites><orcidid>0000-0001-9617-2672 ; 0000-0003-0231-3636 ; 0000-0003-0582-8723 ; 0000-0001-8068-4964 ; 0000-0003-1101-8831 ; 0000-0003-3055-9334</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00266-023-03433-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00266-023-03433-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37407709$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Calim, Muhittin</creatorcontrib><creatorcontrib>Karaaslan, Kazim</creatorcontrib><creatorcontrib>Yilmaz, Sinan</creatorcontrib><creatorcontrib>Senturk, Erol</creatorcontrib><creatorcontrib>Deniz, Hilal</creatorcontrib><creatorcontrib>Akbas, Sedat</creatorcontrib><title>The Effects of Hypocapnia and Hypercapnia on Intraoperative Bleeding, Surgical Field Quality, and Surgeon Satisfaction Level in Septorhinoplasty: A Prospective Randomized Clinical Study</title><title>Aesthetic plastic surgery</title><addtitle>Aesth Plast Surg</addtitle><addtitle>Aesthetic Plast Surg</addtitle><description>Background
Septorhinoplasty (SRP) is one of the most commonly performed procedures in the world for functional and aesthetic purposes. The present study was aimed to compare the effects of hypocapnia and hypercapnia regarding the total amount of intraoperative bleeding, surgical field quality, and surgeon satisfaction level.
Methods
In this randomized prospective clinical study, eighty patients with American Society of Anesthesiologists I–II and were 18–45 years old scheduled for septorhinoplasty were randomly allocated to group hypocapnia [end-tidal carbon dioxide (EtCO
2
) 30 ± 2 mmHg] and group hypercapnia (EtCO
2
40 ± 2 mmHg). We evaluated the total amount of intraoperative bleeding, the surgical field quality, surgeon satisfaction level, hemodynamics and peri- and postoperative adverse events.
Results
Group hypocapnia significantly reduced the total amount of intraoperative bleeding (
p
< 0.001). The surgical field quality and surgeon satisfaction level in group hypocapnia were significantly better than group hypercapnia (
p
< 0.001). EtCO
2
levels of group hypocapnia were significantly lower than group hypercapnia at all time points (
p
< 0.001 for all time points). There were no significant differences between the groups in terms of heart rate and mean arterial pressure at all time points. There were no significant differences between the groups in terms of adverse events
Conclusions
The results of this double-blind randomized clinical trial showed that reducing the amount of intraoperative bleeding for patients with hypocapnia undergoing SRP through known methods (e.g., reverse Trendelenburg head-up position, positive end-expiratory pressure limiting, controlled hypotension, and use of topical vasoconstrictors, corticosteroids, and tranexamic acid) would improve the quality of the surgical field and raise the surgeon satisfaction level.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Hypercapnia</subject><subject>Hypocapnia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Otorhinolaryngology</subject><subject>Plastic Surgery</subject><subject>Prospective Studies</subject><subject>Surgeons</subject><subject>Young Adult</subject><issn>0364-216X</issn><issn>1432-5241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UctuFDEQtBCILIEf4IAsceGQAT9mxjPcwiohkVbisUHiZnk97Y0jrz2xPZGWP-Pv8D4AiQMnq7qrqrtdCL2k5C0lRLxLhLC2rQjjFeE151X_CM1ozVnVsJo-RjPC27pitP1-gp6ldEcIZULUT9EJFzURgvQz9PPmFvCFMaBzwsHgq-0YtBq9VVj5YQchHnHw-NrnqEIpqWwfAH9wAIP16zO8nOLaauXwpQU34C-TcjZvz_Yeux4U8bKIklE62wIW8AAO21KFMYd4a30YnUp5-x6f488xpLFstJvxtViEjf0BA5476_dDlnkats_RE6NcghfH9xR9u7y4mV9Vi08fr-fni0pz1uaqFbT8QsuEbgU3g2GDMACtMESrhnWqo7TpNC-oU4MgqiMCVrVWpGH9ChrFT9Gbg-8Yw_0EKcuNTRqcUx7ClCTrOO97UTNeqK__od6FKfqynWQ9F7TuetIUFjuwdDkzRTByjHaj4lZSInfBykOwsgQr98HKvoheHa2n1QaGP5LfSRYCPxBSafk1xL-z_2P7CzePsRg</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Calim, Muhittin</creator><creator>Karaaslan, Kazim</creator><creator>Yilmaz, Sinan</creator><creator>Senturk, Erol</creator><creator>Deniz, Hilal</creator><creator>Akbas, Sedat</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9617-2672</orcidid><orcidid>https://orcid.org/0000-0003-0231-3636</orcidid><orcidid>https://orcid.org/0000-0003-0582-8723</orcidid><orcidid>https://orcid.org/0000-0001-8068-4964</orcidid><orcidid>https://orcid.org/0000-0003-1101-8831</orcidid><orcidid>https://orcid.org/0000-0003-3055-9334</orcidid></search><sort><creationdate>2024</creationdate><title>The Effects of Hypocapnia and Hypercapnia on Intraoperative Bleeding, Surgical Field Quality, and Surgeon Satisfaction Level in Septorhinoplasty: A Prospective Randomized Clinical Study</title><author>Calim, Muhittin ; Karaaslan, Kazim ; Yilmaz, Sinan ; Senturk, Erol ; Deniz, Hilal ; Akbas, Sedat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-671364627c673fdf2d7fee67f0ca528a81158c30ca8ad70a807eb4ca0529be5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Hypercapnia</topic><topic>Hypocapnia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Otorhinolaryngology</topic><topic>Plastic Surgery</topic><topic>Prospective Studies</topic><topic>Surgeons</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Calim, Muhittin</creatorcontrib><creatorcontrib>Karaaslan, Kazim</creatorcontrib><creatorcontrib>Yilmaz, Sinan</creatorcontrib><creatorcontrib>Senturk, Erol</creatorcontrib><creatorcontrib>Deniz, Hilal</creatorcontrib><creatorcontrib>Akbas, Sedat</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Aesthetic plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Calim, Muhittin</au><au>Karaaslan, Kazim</au><au>Yilmaz, Sinan</au><au>Senturk, Erol</au><au>Deniz, Hilal</au><au>Akbas, Sedat</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Hypocapnia and Hypercapnia on Intraoperative Bleeding, Surgical Field Quality, and Surgeon Satisfaction Level in Septorhinoplasty: A Prospective Randomized Clinical Study</atitle><jtitle>Aesthetic plastic surgery</jtitle><stitle>Aesth Plast Surg</stitle><addtitle>Aesthetic Plast Surg</addtitle><date>2024</date><risdate>2024</risdate><volume>48</volume><issue>2</issue><spage>167</spage><epage>176</epage><pages>167-176</pages><issn>0364-216X</issn><eissn>1432-5241</eissn><abstract>Background
Septorhinoplasty (SRP) is one of the most commonly performed procedures in the world for functional and aesthetic purposes. The present study was aimed to compare the effects of hypocapnia and hypercapnia regarding the total amount of intraoperative bleeding, surgical field quality, and surgeon satisfaction level.
Methods
In this randomized prospective clinical study, eighty patients with American Society of Anesthesiologists I–II and were 18–45 years old scheduled for septorhinoplasty were randomly allocated to group hypocapnia [end-tidal carbon dioxide (EtCO
2
) 30 ± 2 mmHg] and group hypercapnia (EtCO
2
40 ± 2 mmHg). We evaluated the total amount of intraoperative bleeding, the surgical field quality, surgeon satisfaction level, hemodynamics and peri- and postoperative adverse events.
Results
Group hypocapnia significantly reduced the total amount of intraoperative bleeding (
p
< 0.001). The surgical field quality and surgeon satisfaction level in group hypocapnia were significantly better than group hypercapnia (
p
< 0.001). EtCO
2
levels of group hypocapnia were significantly lower than group hypercapnia at all time points (
p
< 0.001 for all time points). There were no significant differences between the groups in terms of heart rate and mean arterial pressure at all time points. There were no significant differences between the groups in terms of adverse events
Conclusions
The results of this double-blind randomized clinical trial showed that reducing the amount of intraoperative bleeding for patients with hypocapnia undergoing SRP through known methods (e.g., reverse Trendelenburg head-up position, positive end-expiratory pressure limiting, controlled hypotension, and use of topical vasoconstrictors, corticosteroids, and tranexamic acid) would improve the quality of the surgical field and raise the surgeon satisfaction level.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37407709</pmid><doi>10.1007/s00266-023-03433-9</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9617-2672</orcidid><orcidid>https://orcid.org/0000-0003-0231-3636</orcidid><orcidid>https://orcid.org/0000-0003-0582-8723</orcidid><orcidid>https://orcid.org/0000-0001-8068-4964</orcidid><orcidid>https://orcid.org/0000-0003-1101-8831</orcidid><orcidid>https://orcid.org/0000-0003-3055-9334</orcidid></addata></record> |
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| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adolescent Adult Hemorrhage Humans Hypercapnia Hypocapnia Medicine Medicine & Public Health Middle Aged Original Article Otorhinolaryngology Plastic Surgery Prospective Studies Surgeons Young Adult |
| title | The Effects of Hypocapnia and Hypercapnia on Intraoperative Bleeding, Surgical Field Quality, and Surgeon Satisfaction Level in Septorhinoplasty: A Prospective Randomized Clinical Study |
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