Comparison of Intraoperative Efficacy of Preoperative Single-Dose Corticosteroid Over Short Course in Functional Endoscopic Sinus Surgery for Nasal Polyposis.

BACKGROUND

Patients having nasal polyposis who do not respond to medical management are subjected for functional endoscopic sinus surgery (FESS). One of the most common complications of surgery is bleeding. One of the strategies to reduce bleeding and securing a dry operating field during surgery is the use of preoperative corticosteroids which shrink the polyps and decrease mucosal inflammation.

AIM

The current study is designed to assess whether preoperative single-dose steroids 24 h before surgery can be a substitute for a 5-day regimen.

METHODS

The proposed study was conducted on 60 patients of unilateral/bilateral nasal polyposis divided into two random groups. Group A was given a single oral dose of 1 mg/kg/dose of prednisolone on the day before surgery. Group B was given 1 mg/kg/day of oral prednisolone for 5 days before surgery. Side effects of steroids in both groups were assessed. Outcome measures were the amount of blood loss, quality of the surgical field, and time taken for the surgery.

RESULTS

The mean age in both groups was similar with the majority of patients being male in both groups. Patients receiving a single dose of corticosteroid have almost no side effects as compared to patients receiving 5-day course. However, patients receiving single doses of corticosteroid preoperatively had significantly more blood loss during surgery. The surgical field in the single dose group was poor and the time taken for surgery was also significantly more.

CONCLUSION

Preoperative single dose of oral corticosteroid can reduce side effects but it is not as effective as short course of preoperative corticosteroid 5-day regimen in case of FESS for nasal polyposis.