1*Final Year Postgraduate, Department of Anesthesiology and Critical Care, Sree Balaji Medical College, Bharath Institute of Higher Education and Research, Tamil Nadu, India. Email: pranavi6157@gmail.com. ORCID: 0009-0002-7370-5418. Mobile: +91 9493615769. Corresponding Author.
2Professor, Department of Anesthesiology and Critical Care, Sree Balaji Medical College, Bharath Institute of Higher Education and Research, Tamil Nadu, India. Email: kalamhn@gmail.com. ORCID: 0000-0003-3502-9535. Mobile: +91 94446 80908
3Assistant Professor, Department of Anesthesiology and Critical Care, Sree Balaji Medical College Hospital, Bharath Institute of Higher Education and Research, Tamil Nadu, India. Email: docgayu@gmail.com. ORCID: 0000-0002-3417-3087. Mobile: +91 9004645828
4Senior Resident, Department of Anesthesiology and Critical Care, Sree Balaji Medical College Hospital, Bharath Institute of Higher Education and Research, Tamil Nadu, India. Email: dr.dipikabalasubramanian@gmail.com. ORCID: 0009-0009-4616-0548. Mobile: +91 9943044266
Received: 12th Dec, 2025; Revised: 12th Feb 2026; Accepted: 13th Feb, 2026; Available Online: 10th March, 2026
Background
Volatile anesthetic agents play a critical role in maintaining intraoperative stability and influencing surgical field conditions. Isoflurane and sevoflurane are widely used inhalational agents; however, their comparative impact on intraoperative bleeding and hemodynamic stability in ear and nose surgeries remains clinically relevant.
Aim
To compare the effects of isoflurane and sevoflurane on intraoperative blood loss, hemodynamic stability, and perioperative hemoglobin changes in patients undergoing ear and nose surgeries.
Methods
This prospective comparative study included 112 adult patients (ASA I–II) scheduled for elective ear and nose surgeries under general anesthesia. Patients were allocated into two groups: Group I (isoflurane) and Group S (sevoflurane). Heart rate, systolic blood pressure, and diastolic blood pressure were recorded at baseline, after drug administration, and at 5, 15, 30, and 60 minutes intraoperatively. Intraoperative blood loss was measured using suction volume and swab estimation. Preoperative and postoperative hemoglobin levels were recorded. Statistical analysis was performed using independent t-test and chi-square test. A p-value <0.05 was considered statistically significant.
Results
Baseline demographic and ASA distribution were comparable between groups (P > 0.05). No statistically significant differences were observed in heart rate or blood pressure at any intraoperative time point (all P > 0.05). Mean intraoperative blood loss was significantly higher in the isoflurane group (133.3±14.14 ml) compared to the sevoflurane group (121.0±42.42 ml; P = 0.0431). Postoperative hemoglobin levels and total hemoglobin drop showed statistically significant differences between groups (P = 0.0033 and P < 0.0001 respectively).
Conclusion
Both anesthetic agents maintained comparable hemodynamic stability. However, sevoflurane was associated with lower intraoperative blood loss and significant perioperative hemoglobin changes. Anesthetic choice may therefore influence operative field conditions in ear and nose surgeries.
Keywords: Isoflurane; Sevoflurane; Anesthesia, General; Anesthetics, Inhalation; Blood Loss, Surgical; Hemodynamics; Hemoglobin; Otorhinolaryngologic Surgical Procedures; Intraoperative Period; Postoperative Period.
How to cite this article: Pranavi V, Kala B, Ramesh G, Dipika. Comparative Evaluation of Isoflurane and Sevoflurane on Intraoperative Blood Loss, Hemodynamic Stability, and Postoperative Hemoglobin Changes in Patients Undergoing Ear and Nose Surgery: A Prospective Observational Study. Int J Drug Deliv Technol. 2026;16(3): 563-569. DOI: 10.25258/ijddt.16.3.63
Source of support: Nil.
Conflict of interest: None