Role of Pterygopalatine Fossa Block on Intra-Operative Heart Rate and Blood Pressure During Endoscopic Sinus Surgery at a Tertiary Care Centre

Abstract

Background: Functional Endoscopic Sinus Surgery (FESS) is a physiological and also well accepted surgical treatment for chronic sinus disease that is unresponsive to medical treatment. The most frequent intraoperative complication is bleeding. Various methods are being tried to reduce the bleeding during FESS. But, none of these methods consistently provide the desirable bloodless field for the surgeons. Blockage of Pterygopalatine Fossa (PPF) through the greater palatine foramen is an alternative approach to reduce blood loss during ESS, which is an easy procedure, associated with little complication. Pterygopalatine Fossa Block (PPFB) along with general anaesthesia is effective in patients undergoing FESS surgery. Aims and Objectives: To assess the effect on and the difference in heart rate and blood pressure after pterygopalatine fossa block during FESS surgery. Materials and Methodology: 25 Patients with bilateral nasal pathology undergoing FESS were selected from ENT wards after a written informed consent. The PPFB was done only on one side, while the opposite nostril acted as control, thus each case acted as their own control. Various vital parameters like – heart rate (HR), blood pressure [(BP) systolic and diastolic] were calculated every 15 mins and their average noted. Surgery on the first side was completed and then followed by surgery on the second side. Applying paired-t Test, results were obtained. Results and Conclusion: There was a significant fall in heart rate and blood pressure. There was a positive correlation between these factors. "p value” was found to be highly significant in both the parameters tested. Pterygopalatine fossa block is an effective adjunct to general anaesthesia for controlling heart rate and blood pressure during FESS surgery.