A 5-year experience in functional endoscopic sinus surgery under local anaesthesia

Abstract

Introduction: Functional endoscopic sinus surgery (FESS) under local anaesthesia performed as an office-based procedure is an alternative to general anaesthesia. It is gaining popularity among otorhinolaryngology – head and neck surgeons. Aim: This study assesses the outcome of FESS performed under local anaesthesia in a tertiary centre over a 5-year period. Material and methods: A retrospective data collection was conducted. All adults who underwent FESS under local anaesthesia for a 5-year period from June 2014 to June 2019 in Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Department, Sarawak General Hospital, Malaysia were included in this study. Data and information on preoperative assessment, surgical indication, sinuses operated on, intraoperative findings and postoperative complications and follow up were recorded. Results and discussion: A total of 150 patients met the inclusion criteria. The most common indication was chronic rhinosinusitis with nasal polyp (78%). All paranasal sinuses were operated on. In 43% of cases local anaesthesia was used alone, while 57% received both local anaesthesia and intravenous anaesthesia. Majority of patients (90%) were discharged home the next day. Four patients (2.7%) developed epistaxis postoperatively which did not require surgical intervention. Conclusions: FESS under local anaesthesia is a safe and feasible alternative to general anaesthesia and is well tolerated by patients. Complications of general anaesthesia can be avoided.