Utilization of total intravenous anesthesia (TIVA) has been proposed as a method to improve
visualization during endoscopic sinus surgery (ESS), largely due to its physiologic decrease
in cardiac output without the peripheral smooth muscle relaxation and resultant vasodilation
associated with inhaled anesthetics. This may be especially important in cases of advanced
inflammatory sinus disease, when visualization may be most compromised. The goal of this
study is to improve clinical practice paradigms by evaluating the use of TIVA versus inhaled
anesthetic for maintenance of anesthesia in ESS for advanced paranasal sinus disease.