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Deliberate hypotension with propofol under anaesthesia for functional endoscopic sinus surgery (FESS)

Overview of attention for article published in Cochrane database of systematic reviews, October 2016
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (62nd percentile)

Mentioned by

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3 tweeters
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2 Facebook pages

Citations

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17 Dimensions

Readers on

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104 Mendeley
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Title
Deliberate hypotension with propofol under anaesthesia for functional endoscopic sinus surgery (FESS)
Published in
Cochrane database of systematic reviews, October 2016
DOI 10.1002/14651858.cd006623.pub3
Pubmed ID
Authors

Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon

Abstract

Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Small bleeding areas can reduce operative visibility and result in destruction of surrounding structures. Deliberate hypotension (lowering the mean arterial blood pressure to between 50 and 65 mm Hg in normotensive patients) using a range of pharmacological agents during general anaesthesia reduces blood loss in many operations. This review was originally published in 2013 and updated in February 2016. We aimed to compare the use of propofol versus other techniques for achieving deliberate intraoperative hypotension during FESS procedures with regard to blood loss and operative conditions. We searched the following databases in the updated review: the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 2), MEDLINE (1950 to February 2016), Embase (1980 to February 2016), LILACS (1982 to February 2016), and ISI Web of Science (1946 to February 2016). We also searched the reference lists of relevant articles and conference proceedings and contacted the authors of included trials. We sought all randomized controlled trials comparing propofol with other techniques for deliberate hypotension during FESS with regard to blood loss and operative conditions in both adults and children. Our primary outcome was total blood loss (TBL). Other outcomes included surgical field quality, operation time, mortality within 24 hours, complications, and failure to reach target blood pressure. We used standard methodological procedures expected by Cochrane. Two review authors independently extracted details of trial methodology and outcome data from the reports of all trials considered eligible for inclusion. We made all analyses on an intention-to-treat basis where possible. When I(2) was less than 40% and the P value from the Chi(2) test was higher than 0.10, we pooled data using the fixed-effect model. Otherwise, we pooled data using the random-effects model. We found no new studies. This updated review therefore includes four studies with 278 participants. Most analyses were based on data from few participants and low-quality evidence, so our results should be interpreted with caution. Deliberate hypotension with propofol did not decrease TBL (millilitres) when compared with inhalation anaesthetics in either children (1 study; 70 participants; very low-quality evidence), or adults (1 study; 88 participants; moderate-quality evidence). Propofol improved the quality of the surgical field by less than one category on a scale from 0 (no bleeding) to 5 (severe bleeding) (mean difference -0.64, 95% CI -0.91 to -0.37; 4 studies; 277 participants; low-quality evidence), but no difference in operation time was reported (3 studies; 214 participants; low-quality evidence). Failure to lower blood pressure to target was less common in the propofol group (risk ratio of failure with propofol 0.24, 95% CI 0.09 to 0.66; 1 study; 88 participants; moderate-quality evidence). Using propofol to achieve deliberate hypotension probably improves the surgical field, but the effect is small. Deliberate hypotension with propofol did not decrease TBL and the operation time. However, due to the very low quality of the evidence, this conclusion is not definitive. Randomized controlled trials with good-quality methodology and large sample size are required to investigate the effectiveness of deliberate hypotension with propofol for FESS.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 104 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 104 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 17 16%
Researcher 15 14%
Student > Postgraduate 13 13%
Student > Doctoral Student 10 10%
Student > Bachelor 9 9%
Other 19 18%
Unknown 21 20%
Readers by discipline Count As %
Medicine and Dentistry 55 53%
Nursing and Health Professions 9 9%
Social Sciences 3 3%
Agricultural and Biological Sciences 3 3%
Psychology 2 2%
Other 9 9%
Unknown 23 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 January 2018.
All research outputs
#6,751,476
of 13,396,694 outputs
Outputs from Cochrane database of systematic reviews
#7,680
of 10,585 outputs
Outputs of similar age
#98,512
of 267,217 outputs
Outputs of similar age from Cochrane database of systematic reviews
#131
of 182 outputs
Altmetric has tracked 13,396,694 research outputs across all sources so far. This one is in the 49th percentile – i.e., 49% of other outputs scored the same or lower than it.
So far Altmetric has tracked 10,585 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.9. This one is in the 27th percentile – i.e., 27% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 267,217 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 62% of its contemporaries.
We're also able to compare this research output to 182 others from the same source and published within six weeks on either side of this one. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.