Background: A clear surgical field is critical during endoscopic sinus surgery (ESS). Hypotensive anesthesia and cardiac output (CO) may optimize the surgical field; however, evidence of their effect on bleeding and cerebral blood flow is conflicting. The aim of this study was to evaluate the effect of blood pressure (BP) and CO on intraoperative bleeding and middle cerebral artery blood flow velocity (V mca ) during ESS.

Hypotensive anesthesia is an effective method of controlling intraoperative bleeding during endoscopic sinus surgery; however the effect is clinically small in low MAP ranges. In otherwise healthy patients undergoing ESS with general anesthesia, reducing MAP to below 60 mm Hg may increase the risk of cerebral ischemia.

Background:The absorption of sodium-deficient, hypotonic irrigation solution is believed to contribute, in certain cases, to hyponatraemia and hypo-osmolality and, in severe cases, to the so-called transurethral resection of the prostate (TURP) syndrome. Methods: The effect of the height of 1.5% glycine irrigation solution during intermittent-flow TURP on serum sodium and osrnolality was studied pen-operatively in 40 patients. The height of the glycine was set at 70 (n = 20) or 150 (n = 20) cm above the operating table. Results: We found no statistically significant difference in the measured serum sodium ( P = 0.929) and osmolality ( P = 0.260) values between the two groups during the 24 hr study period. Conclusions:The height of the irrigation solution is not important in the development of hyponatraemia and hypo-osmolality, and other factors are probably more important.