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

Assessment of a Lateral Nasal Wall Block Technique for Endoscopic Sinus Surgery Under Local Anesthesia

2018 ◽  
Vol 32 (4) ◽  
pp. 318-322 ◽  
Author(s):  
Grace M. Scott ◽  
Chris Diamond ◽  
Damian C. Micomonaco
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Patient Comfort ◽  
Lateral Nasal Wall ◽  
Anesthetic Techniques ◽  
Limited Data ◽  
Wall Block ◽  
Narcotic Analgesia ◽  
Anesthesia Technique ◽  
Strongly Agree

Introduction With increasingly limited operative resources and patient desires for minimally invasive procedures, there is a trend toward local endoscopic procedures being performed in the outpatient clinic setting. However, there remain limited data supporting a technique to adequately anesthetize the lateral nasal wall and provide patient comfort during these procedures. The objective of this study is to assess the efficacy of a novel lateral nasal wall block for use in office-based endoscopic sinus surgery. Methods A prospective cohort study assessing consecutive patients undergoing office-based endoscopic sinus surgery using our described lateral nasal wall block anesthesia technique. Procedural patient comfort was assessed using the Iowa Satisfaction with Anesthesia Scale (ISAS), completed by participants immediately following an office-based endoscopic procedure and prior to discharge from clinic. Postoperative analgesic use was assessed at the first postoperative visit. Results Thirty-five consecutive patients undergoing office-based outpatient endoscopic sinus surgery for chronic rhinosinusitis (with and without polyps) were assessed. The mean ISAS score was 2.83 (95% confidence interval: [2.69, 2.97]). All participants (100%) agree or strongly agree that they were satisfied with their anesthesia care and would want the same anesthetic again. No participant required narcotic analgesia, and 80% used no oral analgesia following the procedure. Conclusions Recent advances in office-based endonasal surgical procedures must be accompanied by the assessment and validation of local anesthetic techniques. The described novel lateral nasal wall block is well tolerated, provides patient satisfaction, and allows for limited use of postprocedure oral analgesics.

Local and Regional Anesthesia for Functional Endoscopic Sinus Surgery

1997 ◽  
Vol 106 (9) ◽  
pp. 767-769 ◽  
Author(s):  
Wai Chung Lee ◽  
Tilak R. Kapur ◽  
Walter N. Ramsden
Keyword(s):  
Regional Anesthesia ◽  
Complication Rate ◽  
Endoscopic Sinus Surgery ◽  
Surgical Complication ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Anesthetic Technique ◽  
Anesthetic Complications ◽  
Regional Anesthetic

An effective topical and regional anesthetic technique using 25% cocaine paste combined with intravenous midazolam hydrochloride was used in 554 patients undergoing functional endoscopic sinus surgery. The operative fields were excellent and all procedures were completed with little patient disturbance. Patients recovered rapidly from sedation and were usually fit for discharge on the same day. There were no anesthetic complications. The major surgical complication rate was 0.5%.

scholarly journals Anesthetic Considerations in Functional Endoscopic Sinus Surgery

2015 ◽  
Vol 7 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Pravin Virappa Ubale
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Anesthetic Techniques ◽  
Anesthetic Considerations ◽  
Surgical Field

ABSTRACT Functional endoscopic sinus surgery is among the most challenging of ENT procedures for a variety of reasons including the need for immobility, hemostasis, and, especially, gentle emergence from anesthesia. Anesthesiologists have contributed significantly, using different anesthetic techniques to control intraoperative hemorrhage, thus significantly improving visualization of the surgical field. How to cite this article Ubale PV. Anesthetic Considerations in Functional Endoscopic Sinus Surgery. Int J Otorhinolaryngol Clin 2015;7(1):22-27.

Ventricular Tachycardia as an Electrocardiography Artifact during Functional Endoscopic Sinus Surgery

2003 ◽  
Vol 17 (2) ◽  
pp. 83-85 ◽  
Author(s):  
Robert R. Gaiser ◽  
Daphne J. Demetry ◽  
Rodney Schlosser
Keyword(s):  
Ventricular Tachycardia ◽  
General Anesthesia ◽  
Operating Room ◽  
Endoscopic Sinus Surgery ◽  
Conscious Sedation ◽  
Electrical Current ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery

Background Functional endoscopic sinus surgery is frequently performed during conscious sedation not provided by an anesthesiologist. Several monitors are used during conscious sedation, one of which is the electrocardiogram (EKG). Equipment used in the operating room may interfere with the EKG tracing. Methods A 30-year-old man underwent his fourth functional endoscopic sinus surgery during general anesthesia. For the procedure, a Xomed Straight Shot microdebrider was used. Results Because of stray electrical current, the use of the microdebrider caused the EKG waveform to resemble ventricular tachycardia. Conclusion This case alerts the clinician to this possible occurrence to prevent inappropriate therapeutics from being initiated.

scholarly journals A Prospective Double-Blinded Randomized Controlled Study Comparing the Efficacy of a Novel Biodegradable Synthetic Polyurethane Foam (Nasopore) vs Standard Polyvinyl Acetate Sponge (Merocel) as Packing Material after Functional Endoscopic Sinus Surgery: The First Indian Experience

2014 ◽  
Vol 7 (3) ◽  
pp. 105-111
Author(s):  
Mohan Kameswaran ◽  
S Raghunandhan ◽  
John K Thomas
Keyword(s):  
Polyurethane Foam ◽  
Endoscopic Sinus Surgery ◽  
Polyvinyl Acetate ◽  
Packing Material ◽  
Functional Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Patient Comfort ◽  
Controlled Study ◽  
Double Blinded

ABSTRACT Background In Indian clinical practice, conventional nasal packing for hemostasis after routine rhinological surgery is usually performed with Vaseline (paraffin) gauze, and rarely with glove-finger packs or tamponade balloons. These materials are tedious to pack and cause discomfort to the patient on removal. Newer nasal packs which have recently emerged in the Indian scenario are found to be more user-friendly, equally effective for hemostasis and less traumatic to the operated nasal mucosa. Most rhinologists today, prefer to use polyvinyl acetate sponge packs (Merocel/Ivalon) for tamponade after nasal surgery. These packs are very effective but non-absorbable and need to be removed which does not augur well with many patients postoperatively. The recent entry of a biodegradable synthetic polyurethane foam (Nasopore) as an alternative nasal packing material, has evoked new interest, which initiated this study. Study method This prospective randomized double-blinded controlled study was aimed to compare the clinical efficacy and patient comfort level, while using Merocel and Nasopore as packing material after functional endoscopic sinus surgery (FESS). This study included thirty adults who were diagnosed with moderate to severe bilaterally comparable chronic rhinosinusitis, who underwent FESS under general anesthesia and received size-matched nasal packs randomly - Merocel on one side and Nasopore on the other. The assessment of clinical efficacy of both packs with regards to ease of packing, hemostasis, pressure effects, infections and adhesions was done with a Diagnostic Nasal Endoscopy at first postoperative day, first week and fourth week after surgery. All Merocel packs were removed on the first postoperative day. Patient comfort levels for both packs were recorded with a standard symptom questionnaire marked on a visual analogue scale of ten and the results were statistically compared between the two groups. Results Comparable outcomes were found while using Merocel or Nasopore with regards to ease of nasal packing and control of postoperative bleeding. There was a statistical difference in the hemostatic property between the two materials in the immediate postoperative period. Five out of 30 patients developed reactionary bleeds with Nasopore, which required repacking with same material within the first 24 hours, but no further bleeds were noted. Two out of these five patients on the first postoperative day had migration of Nasopore toward the choana and had to be repacked with additional Nasopore. Sequential postoperative nasal endoscopy revealed that Nasopore is more mucosal friendly with lesser incidence of adhesions, synechiae, infection and edema, with better biocompatibility and safety. The major success with Nasopore was found to be, the fact that no pack removal was necessary, which immensely improved patient satisfaction and willingness to use the material when compared to Merocel. This was proved by the patient's symptom questionnaire which showed significant benefits of Nasopore over Merocel with regards to compliance and comfort levels. Conclusion Nasopore is a novel biodegradable synthetic material which is clinically as efficacious and patient-friendly as Merocel and is suitable for postoperative nasal packing after functional endoscopic sinus surgery. The clinical benefits of Nasopore and its outcomes among patients as recorded in our study, stands proof to support Nasopore as a successful packing material in rhinological surgery. How to cite this article Raghunandhan S, Kameswaran M, Thomas JK. A Prospective Double-Blinded Randomized Controlled Study Comparing the Efficacy of a Novel Biodegradable Synthetic Polyurethane Foam (Nasopore) vs Standard Polyvinyl Acetate Sponge (Merocel) as Packing Material after Functional Endoscopic Sinus Surgery: The First Indian Experience. Clin Rhinol An Int J 2014;7(3):105-111.

scholarly journals Sinus Surgery: Analysis of Videos Available Online

2021 ◽  
Vol 12 ◽  
pp. 215265672199342
Author(s):  
Arthur Uyesugi ◽  
Shannon Moldowan ◽  
Keighly Bradbrook ◽  
Theodore Schuman
Keyword(s):  
Private Practice ◽  
Endoscopic Sinus Surgery ◽  
Cross Sectional Study ◽  
Functional Endoscopic Sinus Surgery ◽  
Third Party ◽  
Sinus Surgery ◽  
Patient Comfort ◽  
Cross Sectional ◽  
Balloon Sinuplasty

Objectives YouTube is the second most visited website in the world and can be a useful resource for patients to gain insight into surgical procedures. A multitude of studies have evaluated the quality of otolaryngology-specific healthcare information available on the YouTube platform, but to our knowledge, the online content regarding functional endoscopic sinus surgery available on this site has not been systematically evaluated. Study Design Cross sectional study. Setting Online. Methods YouTube was searched using the keywords “sinus surgery.” Variables including video length, total number of views, authorship (academic, private practice physician, patient, or third party), objective (advertisement, informative, or patient perspective), inclusion of intra-operative footage, and discussion of balloon sinuplasty were recorded and analyzed by a single reviewer. Results Two-hundred twenty-two videos met inclusion criteria, with a median length of 4 minutes, and a median of 3349 views. The majority of videos were informative (n = 145, 65%), narrated (n = 151, 68%), and did not mention balloon sinuplasty (n = 189, 85%) nor contain intra-operative footage (n = 116, 52%). Private practice physicians were the most common authors (n = 113, 51%), followed by patients (n = 70, 32%), third parties (n = 28, 13%) and academics (n = 11, 5%). Conclusions Sinus surgery is one of the most common ambulatory procedures performed. Online resources such as YouTube can be useful for improving health literacy and patient comfort with medical topics such as functional endoscopic sinus surgery, but it is important for clinicians and patients to understand that there is a spectrum in the authorship, content, and quality of sinus surgery related videos posted online.

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