Hypotensive Agents Reduce Bleeding in ESS
Diltiazem, esmolol, dexmedetomidine, labetalol, and clonidine were associated with improved surgical field quality and comparable safety profiles
By
Olivia Anderson
January 30, 2026
Clinical Scorecard: Hypotensive Agents Reduce Bleeding in ESS
At a Glance
Category Detail
Condition Endoscopic Sinus Surgery (ESS) Key Mechanisms Controlled hypotension to reduce intraoperative bleeding Target Population Patients undergoing endoscopic sinus surgery for chronic inflammatory sinonasal conditions Care Setting Intraoperative surgical setting
Key Highlights
Diltiazem showed the greatest reduction in bleeding scores. Dexmedetomidine significantly lowered mean arterial pressure by approximately 30 mm Hg. Esmolol and labetalol associated with shorter emergence times. Safety profiles were comparable across all agents studied. Variability in dosing and outcome definitions may limit generalizability. Guideline-Based Recommendations
Diagnosis
Assess chronic rhinosinusitis and nasal polyposis indications for ESS. Management
Select hypotensive agents based on bleeding control, hemodynamic stability, and recovery time. Monitoring & Follow-up
Monitor intraoperative bleeding scores and hemodynamic parameters. Risks
Consider variability in subjective measures of bleeding and visualization. Patient & Prescribing Data
Patients undergoing ESS with chronic sinonasal conditions.
Agent selection should be tailored to individual patient characteristics and procedural goals.
Clinical Best Practices
Utilize multiple pharmacologic options for controlled hypotension during ESS. Standardize timing and dosing protocols in future studies. Emphasize individualized treatment strategies. Related Resources & Content
