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

Vijendra S. Shenoy, Nidhin Prakash, Panduranga M. Kamath, Raghavendra A. Rao, D. Deviprasad, Vishnu Prasad, Vikranth Kamboj, Lavan Kumar Borra

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Functional endoscopic sinus surgery (FESS) is one of most common surgeries in otorhinolaryngology practice. It is done in the narrow confines of the nasal cavity. Bleeding into the surgical field is a major problem faced by endoscopic surgeons. To assess the effectiveness of pterygopalatine fossa infiltration with lignocaine and adrenaline in controlling surgical field bleeding during endoscopic sinus surgery. A randomized blinded study was done among 68 patients who underwent FESS. Infiltration with 2% lignocaine with 1:80,000 adrenaline was given only on one side and the surgeon was blinded as to which side was infiltrated and he was asked to assess the surgical field using a standard scale. There was statistical significant improvement in surgical field on the infiltrated side (p = 0.001) with almost 25–30% improvement in surgical field on the infiltrated side. The surgical field bleeding also varied with the blood pressure with a positive correlation. There were no complications associated with the procedure. Pterygopalatine fossa infiltration with lignocaine and adrenaline is an effective technique in reducing surgical field bleeding during FESS. It can be combined with nasal decongestion or hypotensive anaesthesia for an optimum surgical field.

Original languageEnglish
Pages (from-to)464-473
Number of pages10
JournalIndian Journal of Otolaryngology and Head and Neck Surgery
Issue number4
Publication statusPublished - 01-12-2017


All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

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