BACKGROUNDFunctional endoscopic sinus surgery provides a challenge and an opportunity for the anaesthesiologists to provide surgeons with a surgical field, which can make this delicate surgery more safe, fast and precise. The article discusses causes of bleeding in functional sinus surgery. MATERIALS AND METHODSIt focuses on various techniques and drugs, which can be used by anaesthesiologists to control bleeding. It also discusses the pros and cons of controlled hypotension during this surgery. Various techniques of local instillation of various drugs are discussed. RESULTSVarious drugs and techniques are compared and advantages and disadvantages of each are discussed. CONCLUSIONPremedication with various drugs, techniques of positioning and controlled hypotension are useful for control of bleeding in functional endoscopic sinus surgery.

Background and Aims: Orthopedic operation theater staff is exposed to primary and scattered radiation during various fluoroscopy-assisted operative procedures during their routine working hours. This exposure is associated with significant health hazard. This prospective study is designed primarily to determine the level of radiation exposure among them and to compare it with the current safety guidelines and secondarily to measure the cumulative scattered radiation exposure inside operation theater complex. Subjects and Methods: Total 15 thermoluminescent dosimeters (TLDs) were used during the study. Seven TLDs were used per team and per procedure at designated position. Participating staff were instructed to use personal protective equipment and to wear the TLDs at all times during their study period. TLDs were analyzed at the end of 6 months. Results: The mean value of radiation exposure of anesthesia machine, orthopedic surgeon, anesthetist with TLD above lead apron, anesthetist with TLD below lead apron, and scrub nurse was 0.05, 1.85, 0.1, 0, and 0.625 mSv units, respectively. The highest individual values for orthopedic surgeon, anesthetist with TLD above the lead apron, and scrub nurse were 2.75, 0.1, and 0.7 mSv units, respectively. All these readings were within permissible limit. Conclusions: If standard safety precautions were followed, cumulative ionizing radiation exposure to participating staff as well as scattered radiation exposure within operation theater complex is minimal and within permissible limit. Routine personal dosimetric monitoring is desirable in staff working with fluoroscopy-guided procedure along with the use of personal protective equipment. Periodic training on radiation risk and protection should be conducted for them to heighten the awareness.

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