الفهرس 
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Abstract
Summary
In patients with chronic sinusitis, Functional Endoscopic Sinus Surgery (FESS) is the preferred surgical option as part of treatment after conservative measures have failed. Intraoperative bleeding is the major problem in these endoscopic surgeries. Excessive bleeding impairs operative visibility, prolongs the duration of surgery and anesthesia, and increases the risk of complications. Controlled hypotension is a method in which the arterial blood pressure is decreased in a deliberate but predictable manner to reduce the intraoperative bleeding and enhance the surgical field visibility.
The aim of this study was to compare the efficacy of controlled hypotensive anesthesia with intravenous infusion of phentolamine versus nitroglycerin in patients undergoing Functional Endoscopic Sinus Surgery (FESS) as regarding intraoperative blood loss and hemodynamic stability.
Thirty patients of both sexes, classified as American Society of Anesthesia physical status I and II, aged between 20 and 50 years, and candidates for FESS were randomly allocated into two groups by using the sealed envelope method. group NTG (n=15) received hypotensive anesthesia with nitroglycerin and group PHN (n=15) received hypotensive anesthesia with Phentlamine. After induction and intubation Nitroglycerin and Phentolamine was infused and titrated to obtain a target mean arterial blood pressure (MAP) of 50–65 mmHg. Vitals were recorded at regular intervals. The following parameters were also recorded: duration of surgical interference (time from the beginning to the end of surgical intervention), duration of anesthesia, blood loss volume, the quality of surgical field was evaluated by surgeon using the 0-5 point bleeding scale, time to achievement of the target MAP, total phentolamine and nitroglycerin doses , any adverse effects in the recovery room.
So we concluded that both Nitroglycerin and Phentolamine can be used safely for controlled hypotension in functional endoscopic sinus surgeries. There was no statistically significant difference between Nitroglycerin and Phentolamine in reduction of MAP except at 5 min only with no statistically significant difference between two drugs on HR, ETCO2, SPO2, total phentolamine and nitroglycerin doses, the quality of surgical field using the 0-5 point bleeding scale, the amount of blood loss, the time needed to reach the target blood pressure, duration of surgery, duration of anesthesia and adverse effects and that means the phentolamine is a good option for lowering MAP during FESS as Nitroglycerin.