Effect of Topical Furosemide Efficacy on Reducing Bleeding and Quality of Surgical Field During Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis

Introduction:Bleeding during endoscopic sinus surgery has an unfavorable effect on the surgical field and prolongs the time of surgery. In this study, we assessed the efficacy of topical furosemide on bleeding and the quality of the surgical field during endoscopic sinus surgery.Materials and Methods:In this clinical trial, ۷۶ patients with chronic rhinosinusitis were selected for endoscopic sinus surgery and randomly assigned to two groups, topical furosemide (intervention) and normal saline (control). The intervention group received ۲۰ micrograms of intranasal spray twice daily, and the control group received regular intranasal saline spray, similar to the intervention group. In addition, the quality of the surgical field (scoring by the BOEZAART grading system) and the amount of bleeding during surgeries were measured. All data were analyzed.Results:In the intervention and control groups, the mean surgical bleeding volume was ۱۸۷.۷۰± ۲۴.۷۹ and ۲۲۹.۲۱± ۲۸.۱۸ ml (P <۰.۰۰۱), the mean of Boezaart scale ۲ and ۳ (P <۰.۰۰۱) and the mean of surgical time were ۱۰۶.۵۳±۱۴.۶۷ and ۱۲۶.۶۳ ± ۱۵.۴۲ minutes (P <۰.۰۰۱), respectively. In patients of the intervention group with and without polyps, the mean surgery time was ۹۹.۵۶± ۱۲.۱۵ and ۱۱۸.۸۴ ±۱۰.۰۳ minutes (P <۰.۰۰۱), and the mean bleeding volume during endoscopic sinus surgery was ۱۷۶.۴۶ ± ۲۲.۵۸, ۲۰۸.۴۶ ±۱۲.۱۴ ml (P <۰.۰۰۱) respectively.Conclusions:Our findings showed that nasal, topical furosemide spray significantly reduced the amount of bleeding during endoscopic sinus surgery and time of the surgery and improved the quality of the surgical field.