To study the efficacy of pterygopalatine fossa (PPF) block with 2% xylocaine and 1:80,000 adrenaline on bleeding during endoscopic sinus surgery (ESS).

Single-blinded prospective comparative study was conducted on patients who underwent bilateral functional endoscopic sinus surgery after obtaining written informed consent. The effect of PPF infiltration was tested by injecting 2% xylocaine with adrenaline on test side, and saline on the control side. The test and the control side were determined by block randomization technique. The surgeon was blinded as to which side the test and control drug was to be given. The surgical field was assessed and graded every 15 minutes on both sides according to Boezaart and Vander Merwe scoring system, and the results were compared and analyzed using Mann–Whitney U test.

Thirty-two patients were included in the study, of whom 59.4% were males. Ethmoidal polyposis was the most common diagnosis (50%). The median computed tomography grade and the endoscopic grade of disease in test side and control side were comparable. The mean blood loss grade on test side was 9.0 ± 3.5 and in control side was 10.9 ± 3.5, and the difference was statistically significant. Significant positive correlation was observed between preoperative endoscopic grade of the disease and blood loss during surgery. A statistically significant correlation was also observed between the vital parameters and blood loss.

Pterygopalatine fossa infiltration with 2% xylocaine and 1:80,000 adrenaline reduces bleeding during ESS.

This study is pivotal in devising an additional method for providing a clear bloodless operative field which to date is one of the major challenges faced by the otorhinolaryngologist.

Mathew R, Srinivasa C, Sathyanarayana V, Suryanarayana S, Harsha P. Role of Pterygopalatine Fossa Block in achieving Relatively Bloodless Field during Endoscopic Sinus Surgery. Clin Rhinol An Int J 2017;10(2):62-65.