Comparison of Sodium Nitroprusside- and Esmolol-Induced Controlled Hypotension for Functional Endoscopic Sinus Surgery

Abstract

Comment This study reaches the conclusion that sodium nitroprusside may reverse the vasoconstriction produced by topical and submucosal high-dose epinephrine in patients undergoing endoscopic sinus surgery. Esmolol, on the other hand, was synergistic with epinephrine and produced ideal operating conditions at minimal levels of induced hypotension. These findings make sense and are consistent with our use of sodium nitroprusside to control hypertension when catecholamines are in excess, i.e., pheochromocytoma. What is surprising about this article is that controlled hypotension is necessary in the authors' practice for functional endoscopic sinus surgery. A stable general anesdietic with topical vasoconstrictors usually provides satisfactory operating conditions.