Surgical removal of angiofibroma under hypotensive anesthesia: a retrospective report

Shiv Kumar; Kuldeep Rana; Snehlata Meena

doi:10.18203/issn.2454-5929.ijohns20263384

Authors

Shiv Kumar Department of Otorhinolaryngology and Head and neck surgery, Government Medical College, Kota, Rajasthan, India
Kuldeep Rana Department of Otorhinolaryngology and Head and neck surgery, Government Medical College, Kota, Rajasthan, India
Snehlata Meena Department of Otorhinolaryngology and Head and neck surgery, Government Medical College, Kota, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20263384

Keywords:

Juvenile nasopharyngeal angiofibroma, Hypotensive anaesthesia

Abstract

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a vascular tumor where surgical excision is often complicated by significant intraoperative hemorrhage. While preoperative embolization can reduce bleeding, it is not always available. Induced hypotension is an alternative technique to minimize blood loss.

Methods: We conducted a retrospective review of 62 patients who underwent surgical resection of JNA (without intracranial extension) from March 2010 to December 2025. Patients were divided into three groups: group I (normotensive anaesthesia, n=21), group II (hypotensive anaesthesia induced with propofol and halothane, n=21), and group III (hypotension induced with intravenous nitroglycerine infusion, n=20). The primary outcome measured was intraoperative blood transfusion requirements.

Results: The mean intraoperative blood transfusion requirement was lower in the hypotensive groups (3.2 units in group I vs approximately 1.75 units in groups II and III).

Conclusions: Induced hypotensive anaesthesia was associated with lower reported intraoperative blood transfusion requirements and can be used safely as an alternative to preoperative embolization during surgical resection of JNA.

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