Comparison of Functional Endoscopic Sinus Surgery under Local and General Anesthesia

1993 ◽  
Vol 102 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Paul D. Gittelman ◽  
Joseph B. Jacobs ◽  
Jane Skorina
Keyword(s):  
Blood Loss ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Intravenous Sedation ◽  
New York University ◽  
Major Complications ◽  
Estimated Blood Loss

We present a retrospective comparison of intravenous sedation and general anesthesia techniques employed at New York University—Bellevue Medical Center for functional endoscopic sinus surgery. Some authors have stressed the use of local anesthesia with intravenous sedation in order to avoid complications and reduce blood loss. We have reviewed 232 patients who underwent 401 consecutive ethmoidectomies and maxillary antrostomies. Local anesthesia, employed in 64% of patients, carried an estimated blood loss of 23 mL per side. General anesthesia was associated with an average blood loss of 58 mL per side. The rate of operative complications for local anesthesia was 8.7% per patient, with a 1.6% rate of major complications per side. General anesthesia carried an overall complication rate of 2.4% per patient, with no major complications. General anesthesia is a relatively safe and viable option for endoscopic sinus surgery that in selected cases may be preferable to local anesthesia.

Propofol for maintenance of general anesthesia: A technique to limit blood loss during endoscopic sinus surgery

1993 ◽  
Vol 14 (4) ◽  
pp. 262-266 ◽  
Author(s):  
Keith E. Blackwell ◽  
Douglas A. Ross ◽  
Patricia Kapur ◽  
Thomas C. Calcaterra
Keyword(s):  
Blood Loss ◽  
General Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery

scholarly journals Controlled Hypotension for Functional Endoscopic Sinus Surgery: A Comparative study of Dexmedetomidine and Esmolol

2020 ◽  
Vol 24 (1) ◽  
pp. 37-49
Author(s):  
Md Shafiul Alam Shaheen ◽  
AKM Nurnobi Chowdhury ◽  
Kawsar Sardar ◽  
Mushfiqur Rahman ◽  
Sudhangshu Shekhar Biswas ◽  
...  
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sedation Score ◽  
Sinus Surgery ◽  
Effective Control ◽  
Controlled Hypotension ◽  
Fentanyl Consumption ◽  
Surgical Field ◽  
Group D

Background: Functional endoscopic sinus surgery (FESS) requires effective control of bleeding for better visibility of the operating field and reduced risk of injury to the optic nerve or the internal carotid artery. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objectives: Our study is undertaken to evaluate the efficacy of dexmedetomidine as a hypotensive agent in comparison to esmolol in Functional Endoscopic Sinus Surgery (FESS). Methods: Sixty (60) patients 20 – 50 years of age, ASA I/II scheduled for FESS were randomly assigned to two equal groups of 30 patients each. Patients of group D received dexmedetomidine 1µg/kg over 10 min before induction of anesthesia followed by 0.4 – 0.8 µg/kg/hr infusion during maintenance and group E received esmolol loading dose 1mg/kg was infused over one min followed by 0.4 – 0.8 mg/kg/hr infusion during maintenance to maintain mean arterial blood pressure (MAP) between (55 – 65 mmHg). The surgical field was assessed using Average Category Scale and average blood loss was calculated. Hemodynamic variables (MAP, HR); intraoperative fentanyl consumption and total recovery from anesthesia (Aldrete’s score ≥9) were recorded. Sedation score was determined at 10, 20, 30, 40 & 60 min after tracheal extubation and time to first analgesic demand was also recorded. Results:In both group D and group E reached the desired MAP (55–65 mmHg) with no inter group difference in MAP or HR. Mean intraoperative fentanyl consumption was significantly lower in group D than group E. Recovery time to achieved Aldrete’s score ≥9 were significantly lower in group E compared with group D.The sedation score were significantly lower in group E compared with group D at 10 minutes, 20 minutes and 30 minutes postoperatively. Time to first analgesic demand was significantly longer in group D. Conclusion: The result of this study showed that both dexmedetomidine and esmolol can be used as agents for controlled hypotension and are effective in providing ideal surgical field during FESS. But dexmedetomidine offers the advantage of inherent analgesic, sedative and anesthetic sparing effect. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 37-49

Anesthetic Choice for Functional Endoscopic Sinus Surgery

1992 ◽  
Vol 6 (1) ◽  
pp. 1-4 ◽  
Author(s):  
John A. Fornadley ◽  
Kevin S. Kennedy ◽  
Joseph F. Wilson ◽  
Peter T. Galantich ◽  
Gregg S. Parker
Keyword(s):  
General Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Patient Comfort ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Local Infiltration ◽  
Local Technique ◽  
Local Anesthetic Injection

Controversy continues concerning the optimal anesthetic technique when completing endoscopic sinus surgery. To attempt to investigate the results using different anesthetic techniques, experience with endoscopic sinus surgery over 12 months (233 cases) was retrospectively reviewed. The use of local anesthetic injection with or without regional blocks (specifically ethmoid and greater palatine) was evaluated, as was the choice of general anesthesia versus local technique in a context of blood loss, patient comfort, and complications. Regional block technique appears to add morbidity for little additional benefit. Endoscopic sinus surgery may be performed safely in appropriately selected patients using either general anesthesia or local infiltration with sedation.

scholarly journals Pneumomediastinum after functional endoscopic sinus surgery under general anesthesia -A case report-

2013 ◽  
Vol 64 (4) ◽  
pp. 367 ◽  
Author(s):  
Jung Man Park ◽  
Young-Chul Park ◽  
Jong Nam Lee ◽  
Jun Seok Bae ◽  
Shin Kyu Kang
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery

Major complications of functional endoscopic sinus surgery

1994 ◽  
Vol 19 (3) ◽  
pp. 248-253 ◽  
Author(s):  
V. L. CUMBERWORTH ◽  
R. M. SUDDERICK ◽  
I. S. MACKAY
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Major Complications

The Effect of Deliberate Hypercapnia and Hypocapnia on Intraoperative Blood Loss and Quality of Surgical Field During Functional Endoscopic Sinus Surgery

2007 ◽  
Vol 105 (5) ◽  
pp. 1404-1409 ◽  
Author(s):  
Vladimir Nekhendzy ◽  
Hendrikus J. M. Lemmens ◽  
Winston C. Vaughan ◽  
Edward J. Hepworth ◽  
Alexander G. Chiu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Intraoperative Blood Loss ◽  
Surgical Field

scholarly journals Metoprolol Significantly Improves Visual Clarity and Hemodynamic Parameters during Functional Endoscopic Sinus Surgery

2019 ◽  
Vol 4 (2) ◽  
pp. 1-8
Author(s):  
Ahmed A. Sadek ◽  
Mokhtar Mostafa ◽  
Tarek Abdel-Monem
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Double Blind ◽  
Arterial Blood ◽  
Surgical Field ◽  
Group 2

Background and Objectives: The success of functional endoscopic sinus surgery (FESS) depends on the visual clarity of the surgical field, which is understudied. Controlled hypotension has many advantages for FESS including reduction in blood loss and improved quality of the surgical field. This study determined whether the use of β-blockers as a premedication could improve the operative field in FESS. Methods: Sixty patients aged from 18 to 50 years, undergoing septoplasty and FESS were included in this prospective, randomized, double-blind, placebo-controlled study. Patients were randomly assigned to receive either metoprolol (100 mg, group 1) or a placebo (a vitamin tablet, group 2) 60 min before surgery. Results: The average blood loss and surgery duration were not significantly higher in the placebo group. The surgical field was graded using the Fromme-Boezaart scale, and it was significantly clearer (p < 0.001) in metoprolol group. The mean arterial blood pressure was significantly lower in the metoprolol group after 30 min of induction until the end of surgery (p < 0.001). The heart rate was also significantly lower (p < 0.001) in those who received metoprolol from before induction of anesthesia up to the end of surgery. Conclusion: Metoprolol significantly improves visual clarity and hemodynamics during FESS. We would recommend the use of metoprolol in FESS and septoplasty.

Sign in / Sign up

Export Citation Format

Share Document