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Anaesthesia for endoscopic sinus surgery
Author(s) -
BAKER A. R.,
BAKER A.B.
Publication year - 2010
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2010.02259.x
Subject(s) - medicine , remifentanil , anesthesia , propofol , airway , surgery , endotracheal tube , postoperative pain , general anaesthesia , intubation
Endoscopic sinus surgery is commonly performed and has a low risk of major complications. Intraoperative bleeding impairs surgical conditions and increases the risk of complications. Remifentanil appears to produce better surgical conditions than other opioid analgesics, and total intravenous anaesthesia with propofol may provide superior conditions to a volatile‐based technique. Moderate hypotension with intraoperative β blockade is associated with better operating conditions than when vasodilating agents are used. Tight control of CO 2 does not affect the surgical view. The use of a laryngeal mask may be associated with improved surgical conditions and a smoother emergence. It provides airway protection equivalent to that provided by an endotracheal tube in well‐selected patients, but offers less protection from gastric regurgitation. Post‐operatively, multimodal oral analgesia provides good pain relief, while long‐acting local anaesthetics have been shown not to improve analgesia.