الفهرس 
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Abstract
FESS is a minimally invasive technique that uses nasal endoscopes to widen the nasal passages of the paranasal sinuses to improve sinus ventilation and allow access to topical medicines. This surgery is typically used to treat chronic rhinosinusitis that does not respond to drugs and nasal polyps.
Controlled hypotension is recommended intraoperatively for better visualization of the surgical field to avoid complications resulting from impaired visibility due to excessive bleeding.
Hypotensive techniques used for controlled hypotension during FESS can be done by drugs such as nitrates, high doses of potent inhaled anesthesia, beta-adrenergic blockers, and or magnesium sulfate.
Local anesthesia and regional anesthesia (e.g., pterygopalatine fossa block), are used for hemodynamic stability during FESS with advantages such as shortening the operating time and reducing blood loss.
It also eliminates GA emergence phenomena, reduces the incidence of PONV, and facilitates patient discharge but overdose may induce neurotoxicity, and the technique itself may cause hematoma or nerve injury.
PFB is an accurate, simple, and safe technique with the advantage of providing surgical analgesia and prolonged postoperative pain relief.
The PPF contains many important neurovascular structures including the maxillary nerve which communicates with SPG within the PPF.