Hypotensive Anesthesia with Propofol Infusion Pump: A Boon for Endoscopic Sinus and Nasal Polyps Surgery

Background: Successful outcome of endoscopic sinus surgery depends on complete visualization of the operative field and intraoperative control of bleeding. Major disadvantage of general anesthesia is the increased bleeding encountered, which can interfere with optimum visualization of the intranasal anatomy unless hypotensive methods are used. Objectives: To study the different anesthetic techniques in relation to their impact on blood loss and duration of surgery. The role of propofol was also evaluated. Design: Department of Anesthesia and ENT, Head and Neck Surgery, KVG Medical College and Hospital, Sullia, Karnataka, India. Materials and methods: 213 cases of endoscopic sinus surgeries done for nasal polyposis, sinusitis, dacryocystitis and septorhinoplasties under local and general anesthesia were evaluated between June 2009 and August 2010. Result: A good operative field was seen with propofol anesthesia compared to halothane anesthesia. The problems of fogging and frequent suctioning were lesser with propofol hypotensive anesthesia. Conclusion: Hypotensive anesthesia using propofol infusion is the anesthesia of choice for extensive nasal polyposis. Propofol when used both for induction as well as maintenance of general anesthesia in endoscopic sinus surgeries significantly reduces the blood loss, thereby improving the visibility of the endonasal structures and minimizes the chance of complications related to endoscopic sinus surgery.