Is Pterygopalatine Fossa Injection with Adrenaline an Effective Technique for Better Surgical Field in Fess?

Area of Science:

• Otorhinolaryngology
• Surgical Anesthesia

Background:

• Functional endoscopic sinus surgery (FESS) is a common procedure performed in the nasal cavity.
• Surgical field bleeding is a significant challenge for endoscopic sinus surgeons, potentially compromising patient safety and surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy of pterygopalatine fossa infiltration with lignocaine and adrenaline in controlling intraoperative bleeding during FESS.
• To assess the impact of this infiltration technique on surgical field quality.

Main Methods:

• A randomized blinded study involving 68 patients undergoing FESS.
• One side of the nasal cavity received pterygopalatine fossa infiltration with 2% lignocaine and 1:80,000 adrenaline; the other side served as the control.
• Surgeons assessed surgical field quality using a standardized scale, blinded to the infiltrated side.

Main Results:

• A statistically significant improvement in surgical field quality was observed on the infiltrated side (p=0.001).
• An approximate 25-30% improvement in surgical field visualization was noted on the infiltrated side.
• Surgical bleeding showed a positive correlation with blood pressure; no complications were associated with the infiltration.

Conclusions:

• Pterygopalatine fossa infiltration with lignocaine and adrenaline is an effective method for reducing surgical field bleeding in FESS.
• This technique can be utilized alongside nasal decongestion or hypotensive anesthesia to optimize the surgical field.