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Dr. Andrew Rynne

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Recommended surgery for sinusitis. Get paranoid when think of anaesthesia. What to do?

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Dr. Prahlad Duggal

ENT Specialist

Practicing since :1998

Answered : 784 Questions

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Posted on Mon, 9 Dec 2013 in Ear, Nose and Throat Problems
Question: Hello dr , my name is XXXXXXX my question to you is I have a severe sinusitis problem my doctors have told me to do d surgery but d thing is I get very parnoid n at hypertension thinking of GENERAL ANETHESIA, howerever, I told him and requested him for local anethesia he said it becomes dangereous when they operate all d fluid n blood goes down the troat becomes bad. But I've seen and heared dr do it under local. What is it I can do I really really wanna go under local I'll go mad thinking of genereal pls suggest and advise with a valuable information. Thank u
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Answered by Dr. Prahlad Duggal 1 hour later
Brief Answer: Both types of anaesthesia have pros and cons Detailed Answer: Hi XXXXXXX Thanks for query, You have stated that you have sinusitis and have XXXXXXX recommended surgery for this. Your CT scan report is mucosal thickening in both maxiilary and right ethmoid sinuses. You have taken a course of augmentin. I suppose your doctor has already tried the short course of oral steroids and steroid nasal sprays along with other symptomatic treatment and after that has recommended surgery. Surgery for sinusitis can done under local as well as general anaesthesia depending upon quantum of disease, patient preference and doctor preference Many surgeons perform most of the endoscopic sinus surgeries under general anaesthesia and many do these under local anaesthesia irrespective of the extent of disease. Some surgeons perform endoscopic surgeries under local for patients with limited disease and under general anaesthesia for patients with extensive disease. Patient preference is also taken in to account in most of the cases but few surgeons prefer all these surgeries under general as they find it uncomfortable doing it under local. Getting operated under local requires patient co-operation as it is a bit uncomfortable especially while surgeon is applying and injecting local anaesthetic agent. The problem of blood going down throat can occur but usually under local, the surgeon keeps on talking to the patient in between and giving commands like keep on swallowing and do not stop breathing. In between the surgery, local anaesthetics are applied again and again and also in the areas which are getting exposed and in expert hands extensive disease can be cleared under local. By experience I mean experienced in operating under local. Posterior disease poses more problem in clearing than anterior and thus is easier to do under general. Your CT report is showing right side posterior disease, will need more co-operation from you on right side. So, please find a surgeon who is comfortable doing it under local as I suppose the patient motivation will not be lacking in a patient like you. The other side is, general anaesthesia is very safe now a days and can be used even in high risk patients, you being a young female should not be any problem. But general anaesthesia does carry an inherent risk which is more that local. So, please weigh your options and if you are dead sure that you want it under local, just find a doctor who is routinely doing these surgeries under local. Wish you good health.
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