Abstract:

Functional endoscopic sinus surgery (FESS) is considered one of the most common surgical procedures. General anesthesia (GA) is usually required during FESS. Regional analgesic techniques can be used during GA that inhibit the intra- and post-operative detrimental stimuli.

Purpose of the study: To evaluate the efficacy of injection of local anesthetics in the sphenopalatine ganglion endoscopically trans-nasally on hemodynamics during endoscopic sinus surgery (FESS) under general anesthesia.

Basic procedures: This prospective randomized, double-blind controlled study was conducted on 60 adult patients of both sex who were undergoing general anesthesia for elective bilateral FESS. The patients were allocated into three groups (20 patients in each group). Group I received sphenopalatine ganglion block by 2ML saline injection alone (C group) as a control group, Group II received sphenopalatine ganglion block by local anesthetic injection 2 ML bupivacaine 0.5% (B group) & Group III received sphenopalatine ganglion block by (1.5 ML bupivacaine 0.5% + 0.5 ML MgSo2 10%) as (group M). Observed variables included hemodynamic parameters (HR&MAP).

Main findings: The results have shown that the regional anesthesia in Group B&M could achieve a stable hemodynamic profile with no need for using risky hypotensive drugs and B blockers.

Principal conclusion

The use of SPGB before sinus surgery has been shown to be a safe, easy, less invasive, and practical approach for controlled hemodynamics.