Name of the Procedure:

Anesthesia for procedures on nose and accessory sinuses; radical surgery
Common name(s): Nasal and Sinus Surgery Anesthesia, Radical Sinus Surgery Anesthesia

Summary

This procedure involves the administration of anesthesia to ensure that a patient is unconscious and pain-free during extensive surgical procedures on the nose and surrounding sinus areas. These surgeries often aim to address complex or chronic conditions.

Purpose

Anesthesia for nasal and sinus surgeries aims to:

• Eliminate pain and discomfort during radical surgical interventions.
• Ensure patient immobility for surgical precision.
• Provide a controlled environment for managing complex nasal and sinus conditions, such as severe sinusitis, tumors, or structural abnormalities.

Indications

• Chronic or recurrent sinus infections not responding to medical treatment.
• Nasal or sinus tumors.
• Structural abnormalities obstructing normal function or causing significant symptoms.
• Persistent nosebleeds.
• Complex sinus diseases requiring surgical intervention.

Preparation

• Fasting for 6-8 hours before surgery.
• Reviewing and possibly adjusting current medications with the healthcare provider.
• Pre-operative diagnostic tests such as blood work, imaging (CT or MRI scans), and a full medical evaluation.
• Discussing anesthesia plans and signing informed consent.

Procedure Description

1. Patient is brought to the operating room and monitored (heart rate, blood pressure, oxygen levels).
2. Intravenous (IV) line is placed for medication administration.
3. Anesthesia induction: Medications are administered through the IV to induce unconsciousness.
4. Airway management: Placement of a breathing tube or other airway devices.
5. Continuous monitoring and anesthesia maintenance throughout the surgery.
6. At the end of surgery, anesthesia is gradually reduced, and the patient is transitioned to recovery.

Tools/Equipment: IV cannulas, anesthesia drugs, airway devices (endotracheal tube), monitoring systems.

Duration

The total anesthesia time correlates with the length of the surgical procedure, typically ranging from 1-4 hours.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Anesthesiologist or a nurse anesthetist (CRNA)
• Surgeons specialized in ENT (Ear, Nose, and Throat)
• Operating room nurses and surgical technicians

Risks and Complications

• Common risks: Nausea, vomiting, sore throat, dizziness, or drowsiness post-anesthesia.
• Rare risks: Allergic reactions, aspiration, anesthesia awareness, cardiovascular complications.
• Management: Close monitoring, pre-operative assessments, and emergency protocols in place.

Benefits

• Pain-free surgery.
• Improved surgical outcomes due to patient immobility.
• Allows for more complex and precision-based surgeries.

Recovery

• Monitoring in recovery room until awake and alert.
• Instructions on managing pain and nausea.
• Rest, limited physical activity for several days.
• Follow-up appointments for surgical evaluation.

Alternatives

• Local anesthesia with sedation (limited to simpler procedures).
• Medications for symptom management alone.
• Pros: Non-invasive or less invasive.
• Cons: May not provide adequate pain control or conditions warranting surgery.

Patient Experience

• During: Patient is unconscious and does not experience any sensations.
• After: Gradual awakening with potential mild discomfort (sore throat, mild pain).
• Pain is managed through prescribed medications.
• Support and comfort measures include warm blankets, hydration, and professional nursing care.