Control of Bleeding in Endoscopic Skull Base Surgery: Current Concepts to Improve Hemostasis

Table 3

Review of controlled hypotension series in endoscopic endonasal surgery.

Author (Year)	Target mean arterial pressure	Grading quality of surgical field		Blood loss	Comment
Boezaart et al. [32] (1995)	>65 mmHg; 60–64 mmHg; 55–59 mmHg; 50–54 mmHg	In SNP group*; 3.63±0.22; 3.50±0.50; 3.31±0.56; 3.05±0.55	In Esm group*; 2.94±0.34; 2.82±0.65; 2.87±0.39; 2.48±0.36	N/A	The optimum surgical conditions were provided with minimum Esm-induced hypotension (MAP > 65 mmHg); conversely, SNP induced hypotension (MAP 50–54 mmHg)
Jacobi et al. [33] (2000)	Moderate controlled hypotension with SNP (65–75 mmHg)	2.38±0.77^§		278±110 mL	(i) Total blood loss and grading quality of surgical field did not show significant difference between the groups; (ii) There was no correlation between blood loss and MAP
	Normotensive situation	2.25±0.63^§		245±132 mL
Mengistu et al. [34] (2007)	Controlled hypotension group 50–55 mmHg	N/A		In Esm group 549±208 mL; In SNP group 557±192 mL	Blood loss shows significant difference between the controlled hypotension group and controlled group
	Controlled group 70–80 mmHg	N/A		883±465 mL

∗Using quality scale is proposed by Fromme et al. [35];§Using numeric rating scale.
SNP: sodium nitropusside; Esm: esmolol; MAP: mean arterial pressure.