IV desmopressin may reduce bleeding, enhance vision for surgeon during endoscopic sinus surgery

The study is published in the American Journal of Otolaryngology.

DDAVP causes the release of von Willebrand's antigen from the platelets and the cells that line the blood vessels where it is stored. Von Willebrand's antigen is the protein that carries factor VIII. This increase in von Willebrand's antigen and factor VIII helps to stop bleeding. Bleeding during functional endoscopic sinus surgery has always been a challenge for the quality of surgical field for surgeons. There are very few studies in the literature which state the effect of desmopressin during endoscopic surgeries especially in patients with chronic rhinosinusitis.

Hence, Fatemeh Hajimohamadi and colleagues from the Anesthesiology Research Center, Tehran University of Medical Sciences, Tehran, Iran carried out the present study to determine whether Desmopressin (DDAVP) can alter bleeding and improves surgeon visual field and decrease operation time or lessen use of anesthesiology medication in a clinical trial study.

The authors conducted this randomized clinical trial using the permuted block randomization method. The authors assessed a total of 44 patients, all of whom were enrolled in study and divided into two equal intervention-control groups.

The intervention group received maximum dose of 0/2 micrograms per kg of DDAVP. In the control group, 30 min before the surgery, 100 ml of normal saline will be injected.

The results of the study highlighted that –The amount of bleeding was 517/17 cc in control group during surgery while it was 387/72 cc in group receiving DDAVP which is significantly lower.

The satisfaction of surgeon regarding suitable visual field was 6/45 in control group while it was 3/77 in DDAVP receivers which is lower.

Hence, it was concluded that "intravenous DDAVP can reduce bleeding during surgery and offer an enhanced vision for surgeon during surgery but it has no potential efficacy on reduction of period of surgery and need for anesthesiology medication like remifentanil and isoflurane."