US EPA

5402860 

Journal Article 

Review 

Anesthesia for functional endoscopic sinus surgery 

Carlton, DA; Govindaraj, S 

2017 

0 

Current Opinion in Otolaryngology and Head and Neck Surgery
ISSN: 1068-9508
EISSN: 1531-6998 

25 

1 

24-29 

English 

28005566 

10.1097/MOO.0000000000000322 

WOS:000392100000005 

PURPOSE OF REVIEW: The present article summarizes anesthetic techniques used during functional endoscopic sinus surgery to decrease bleeding and aid in creating a clear surgical field. The applicable physiology behind these anesthetic techniques is reviewed with emphasis on the effect on bleeding and the surgical field. Deliberate hypotension, reverse Trendelenburg positioning, regional anesthesia, and cerebral monitoring are discussed.

RECENT FINDINGS: There are mixed data as to whether traditional inhalation anesthesia or total intravenous anesthesia is superior with respect to better surgical fields and decreased blood loss. A review of the literature tends to favor total intravenous anesthesia. Cerebral oximetry and transcranial Doppler ultrasound are emerging techniques to monitor cerebral perfusion during deliberate hypotension.

SUMMARY: Total intravenous anesthesia using propofol and remifentanil is the current favored technique for producing deliberate hypotension during endoscopic sinus surgery due to its hemodynamic stability and smooth rapid emergence. 

anesthesia; deliberate hypotension; functional endoscopic sinus surgery