The Effectiveness of Total Intravenous Anesthesia (TIVA) in Functional Endoscopic Sinus Surgery (FESS)

Abstract

A 58-year-old female presented for Functional Endoscopic Sinus Surgery (FESS) to treat chronic rhinosinusitis. FESS is the mainstay treatment currently for chronic rhinosinusitis, with or without nasal polyps. Goals for FESS include optimal visualization of anatomical structures with minimal bleeding in the surgical field.¹ The anesthetic technique chosen, either total intravenous anesthesia (TIVA) or inhalational anesthesia (IA), has shown to affect the visibility of the sinonasal mucosa, dictating the outcome of intraoperative blood loss. The difference between these agents are how they produce vasodilation in the body, particularly in the nasal mucosa.^2,7,8 Current evidence supports TIVA as the superior anesthetic technique in FESS, as it has shown to successfully reduce intraoperative blood loss with superior surgical visibility.