Reducing bleeding during FESS

This article discusses the importance of anesthesia in endoscopic sinus surgery. Major aim of anesthetist in FESS should be to reduce blood pressure to such a level that bleeding is minimized. It also discusses the various steps that should be followed by surgeons to reduced intra operative bleeding during the procedure.

Introduction:

Bleeding is one complication that could increase the risk of complication during endoscopic sinus surgery.

Considerable amount of attention should be paid to reduce bleeding on the table during the surgical

procedure. Dry surgical field not only improves visibility during endoscopic sinus surgery, it also shortens the

duration of surgery. In this regard both anesthesiologist and the operating surgeon have a vital role to play.

Endoscope becomes rather useless when the operating field bleeds. Bleeding is more common if surgery is

performed on allergic / inflamed nasal mucosa. This is where operating surgeon should take extra precaution

in preparing the patient. Reduction of nasal allergy and inflammation is also known as mucosal preparation

prior to surgery. This is done by administering a course of antibiotic, antihistamine and topical steroid spray ¹.

Ideally patient should be prescribed these medications at least 1 week prior to surgery.

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