Intravenous lidocaine in endoscopic sinus surgery

Intraoperative Bleeding Control with Terlipressin in Functional Endoscopic Sinus Surgery

“…There is no doubt that FESS procedures in the GA setting require local tissue bleeding control. [4][5][6][7]16 There are a few ways to reduce BI: hemostatic therapy, 17,18 induced hypotension, 3,7,9 administration of beta blockers, [19][20][21] or glucocorticoids. 22,23 In clinical practice, terlipressin is generally used for hepatorenal syndrome, bleeding control in abdominal and pelvic surgery, and gastrointestinal, urinary, or obstetric bleeding.…”

“…All FESS procedures were performed by the same surgeon, who did not know about terlipressin administration and evaluated the BI on a 6-point scale of mean values (Fromme-Boezaart Score). 5 In this scale, 0 points indicate no bleeding in the surgical field, whereas 5 points indicate severe bleeding that completely reduces visibility and makes it impossible to continue the procedure.…”

“…Even small amounts of bleeding can considerably limit surgical field visualization, thus disrupting the surgical plan and causing complications. 4,5 Increased extent of bleeding may correlate with more intensive peripheral blood flow caused by nitroglycerin or a greater depth of anesthesia, particularly the inhalational type. 6,7 A solution for this issue in FESS may lie in terlipressin, which is a synthetic analog of vasopressin successfully used in obstetrics.…”