Anesthesiologic viewpoints of endonasal paranasal sinus surgery

There must be close cooperation between the surgeon and the anaesthetist during surgery of the paranasal sinuses. The surgeon needs a bloodless field which the anaesthetist can achieve by lowering the patient's arterial blood pressure using controlled hypotension. Controlled hypotension carries considerable risks, and only selected cases should be treated with this method. There are two hypotensive drugs of choice: sodium nitroprusside and nitroglycerin. If the circulation and ventilation are monitored sufficiently, the surgeon can expect good results with diminished blood loss.