Anaesthetic Concerns for Functional Endoscopic Sinus Surgery

Abstract

BACKGROUND Functional 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 METHODS It 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. RESULTS Various drugs and techniques are compared and advantages and disadvantages of each are discussed. CONCLUSION Premedication with various drugs, techniques of positioning and controlled hypotension are useful for control of bleeding in functional endoscopic sinus surgery.

Efficacy of morphine sulphate versus nalbuphine during functional endoscopic sinus surgery on intra-operative bleeding:A prospective, randomized, double blind study

“…Opioids cause a drop in blood pressure during anaesthesia and minimizes surges in blood pressure due to surgical pain. (22) Bleeding scores were between 2 and 3 with no statistical significant differences between both groups.…”

Induced Hypotension in Functional Endoscopic Sinus Surgery: A Comparative Study of Dexmedetomidine and Esmolol

“…All surgical incisions involve cutting of the blood vessels, where simple persistent oozing may add much difficulty to even the simplest surgical procedures while massive bleeding can be hazardous and require transfusion. Deliberately induced hypotension is a method to produce a controlled and safe reduction in the arterial blood pressure (BP) while preserving organ perfusion by reducing the BP of the patient by almost 20% by decreasing capillary ooze [ 1 ]. It is the prime concern of every ENT surgeon to delineate the intricate anatomy and thus the need for a bloodless, clear operative field, which is obtained by induced systemic hypotension.…”

Efficacy of Oral Clonidine as Premedication on Intraoperative Bleeding and Consumption of Inhalational Agent in Patients Undergoing Functional Endoscopic Sinus Surgery

“…Excessive bleeding can hinder the visualization of the anatomical structures in the surgical field. Tissue damage can lead to the development of post-operative adhesions and surgical complications like dura puncture, CSF leak, orbital and optic nerve trauma, extensive hemorrhage and procedure failure are more likely to ensue due to poor visibility of the surgical field [2]. This is a major limitation of this surgery and can affect the surgical outcome.…”