Impact of Pterygopalatine Fossa Injection with Local Anesthetic and Adrenaline on Nasal Bleeding During Endoscopic Sinus Surgery

Bendary, Bothina Ahmed Mohammed; Abd Elgaber, Fatma Mohammed; Kopia, Sara Mamdouh Mohammed; Elsayed, Rasha Lotfy

doi:https://doi.org/10.21608/aimj.2025.446629

Impact of Pterygopalatine Fossa Injection with Local Anesthetic and Adrenaline on Nasal Bleeding During Endoscopic Sinus Surgery

Document Type : Original Article

Authors

¹ Department of Otolaryngology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

² Department of Anesthesia and Intensive care unit, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.

https://doi.org/10.21608/aimj.2025.446629

Abstract

Background: The most effective management for chronic rhinosinusitis that is resistant to medical treatment is endoscopic sinus surgery (ESS).
Aim: To evaluate the effect of pterygopalatine fossa injection with local anesthetic and adrenaline on intraoperative surgical field hemorrhage, operative time, and total loss of blood throughout functional ESS.
Methods: A prospective comparative double-blind randomized controlled trial investigation has been performed in the otolaryngology department and the operative room at AL-Zahraa hospital, Al-Azhar University. Participants have been recruited from the otolaryngology outpatient clinic between November 2023 and November 2024.
Result: The statistically significant distinction (p-value equal 0.002) in the mean endoscopic grading of hemorrhage during surgery on the side of the PPF block and the side without the PPF block was 2.80±0.0.39 and 3.53±0.44, correspondingly. The mean time of surgery on the side with the PPF block was 54.63±17.77 minutes, while the mean operative time on the side without the PPF block was 63.38±18.45 minutes. The distinction was statistically significant (p-value equal 0.034). The mean amount of blood loss on the side with the PPF block was 132.50±31.68 ml, while the mean number of milliliters on the side without the PPF block was 162.50±49.89. The distinction was statistically significant (p-value equal 0.024).
Conclusion: The bleeding during the operation significantly decreased and the visualization of the surgical field throughout ESS was enhanced by infiltrating PPF with two percent xylocaine and 1:100,000 adrenaline. It additionally significantly decreases the total amount of blood loss and the duration of surgery.

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