Multimodal blood loss prevention bundle for endoscopic resection of juvenile nasopharyngeal angiofibroma: A case series

Author:

Jain Ruchi A.1ORCID,Parikh Devangi A.1ORCID,Miranda Roshni C.2ORCID

Affiliation:

1. Department of Anaesthesia, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India

2. Department of Community Medicine, HBT Medical College and Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India

Abstract

Surgery for excision of juvenile nasopharyngeal angiofibroma (JNA) carries the possibility of massive life-threatening haemorrhage. Anaesthetic management aims to maintain haemodynamic stability and reduce blood loss. This case series describes the application of the bundled approach as a multimodal blood loss prevention bundle (MBLPB). Twenty patients underwent 23 surgeries with MBLPB. The blood loss and the number of units of blood transfused were recorded. The surgeon satisfaction score was assessed. The median [interquartile range (IQR)] estimated blood loss was 1300 (650–2350) ml. Patients with tumours in stages I and II had a median (IQR) blood loss of 550 (270–750) ml compared to patients with higher grades of tumours (stages III, IV) with a median (IQR) blood loss of 2100 (1300–2500) ml. Median (IQR) units of packed red cells transfused was 1 (0–3). The surgeon’s satisfaction score was high when MBLPB was applied for JNA. However, it does not appear to reduce blood loss markedly.

Publisher

Medknow

Reference11 articles.

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