title: Anesthesia for functional endoscopic sinus surgery.
abstract: OBJECTIVE
  The present article summarizes anesthetic techniques used during functional endoscopic sinus surgery to decrease bleeding and aid in creating a clear surgical field. The applicable physiology behind these anesthetic techniques is reviewed with emphasis on the effect on bleeding and the surgical field. Deliberate hypotension, reverse Trendelenburg positioning, regional anesthesia, and cerebral monitoring are discussed.
  
  
  RESULTS
  There are mixed data as to whether traditional inhalation anesthesia or total intravenous anesthesia is superior with respect to better surgical fields and decreased blood loss. A review of the literature tends to favor total intravenous anesthesia. Cerebral oximetry and transcranial Doppler ultrasound are emerging techniques to monitor cerebral perfusion during deliberate hypotension.
  
  
  CONCLUSIONS
  Total intravenous anesthesia using propofol and remifentanil is the current favored technique for producing deliberate hypotension during endoscopic sinus surgery due to its hemodynamic stability and smooth rapid emergence.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery at Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Carlton
authors.forename: Satish
authors.initials: S
authors.lastname: Govindaraj
mesh_terms: D058109:Airway Management / Q000379:methods; D000758:Anesthesia / Q000379:methods*; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010254:Paranasal Sinus Diseases / Q000503:physiopathology / Q000601:surgery; D056888:Patient Positioning; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil; D012220:Rhinitis / Q000175:diagnosis / Q000601:surgery*; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol