副鼻腔炎手術の出血に関する研究

抄録

In order to know the cause why the amount of bleeding during sinus operation is remarkablly different from case to case, the author investigated the relation between the amount of the bleeding in maxillo-ethmoidectomy, systemic and local findings and anesthesia.
In most cases examined, the systemic conditions such as bleeding time, coagulation time, prothrombin time, blood pressure and skin capillary wall resistance were proved to be normal and there was no significant relation to the amount of bleeding, while in few cases with abnormal values in the tests, bleeding was rather remarkable.
Local conditions such as abundant blood supply to the area, and vascular dilatation and engorgement due to the severe inflammation were the effective causes of profuse bleeding.
In anesthesia, precise blocking of maxillary nerve reduced the amount of bleeding, while general anesthesia (endotracheal anesthesia) increased the amount of bleeding, because of the dilatation of peripheral blood vessels.
The amount of bleeding under potentiated narcosis was minimal, one of the main causes of which was the lowered blood pressure.
In the author's investigation as mentioned above, it seemed that the amount of bleeding in each case was decided by the systemic and local conditions, the method enployed and skill in anesthesia in relation to one another.