Comparison of functional endoscopic sinus surgery under local and general anesthesia

We present a retrospective comparison of intravenous sedation and general anesthesia techniques employed at New York University-Bellevue Medical Center for functional endoscopic sinus surgery. Some authors have stressed the use of local anesthesia with intravenous sedation in order to avoid complications and reduce blood loss. We have reviewed 232 patients who underwent 401 consecutive ethmoidectomies and maxillary antrostomies. Local anesthesia, employed in 64% of patients, carried an estimated blood loss of 23 mL per side. General anesthesia was associated with an average blood loss of 58 mL per side. The rate of operative complications for local anesthesia was 8.7% per patient, with a 1.6% rate of major complications per side. General anesthesia carried an overall complication rate of 2.4% per patient, with no major complications. General anesthesia is a relatively safe and viable option for endoscopic sinus surgery that in selected cases may be preferable to local anesthesia.