الفهرس 
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Abstract
When conservative therapy fails, functional endoscopic sinus surgery (FESS), a highly advanced kind of surgery, has transformed the surgical management of acute and chronic sinus conditions. Bleeding reduces eyesight in the surgical region, slows down the procedure, and raises the chance of FESS while under general anesthesia (GA). The best strategy to reduce intraoperative bleeding may be to induce systemic hypotension.
During functional endoscopic sinus surgeries, using an intentional hypotensive anesthetic technique has a number of important advantages, such as a reduction in blood loss and, consequently, a reduction in the need for blood transfusions, an improvement in the surgical environment, and a reduction in the length of the procedure. During hypotensive anesthesia, the patient’s mean arterial pressure (MAP) is lowered by 30% or maintained between 60 and 70 mm Hg.
Among the adverse effects of induced hypotension that need medical treatment include ischemia to vital organs, cerebral hypoperfusion, severe renal injury, and acidosis.
An increase in serum creatinine levels, a decrease in urine output, the need for renal replacement therapy (dialysis), or a combination of these variables may all result in an acute kidney injury, which is defined as a rapid (within 48 hours) deterioration in kidney function.
Acute kidney injury (AKI) in its early stages is still difficult to predict using clinical and analytical approaches. A potential non-invasive biomarker of kidney damage has been identified as neutrophil gelatinase-associated lipocalin (NGAL).
The goal of the present research was to evaluate acute kidney injury (AKI) after induced hypotension during FESS surgery.
Between April 2021 and April 2022, the otolaryngology division at Minia University Hospital recruited 20 patients who were qualified for the FESS (Endoscopic functional sinus surgery).
The main results of the study revealed that:
Information about the sample population (n=20), which consisted of 11 men (55 percent) and 9 women (45%), with a mean age of 36.50.
The study population’s respiratory rate did not substantially alter throughout the pre-operative, intraoperative, or post-operative phases.
The amount of urine produced before to and during surgery was considerably different.
The Wilcoxon Signed Ranks Test found no statistically significant change in the levels of urea and creatinine between preoperative, 3 hours after surgery, and 3 days after surgery.
In the study group, there were substantial differences in NGAL preoperatively and three hours after surgery.
The population under study’s pre-operative, intra-operative, and post-operative oxygen saturation readings did not significantly vary from one another.
Heart rates before and after surgery were quite different from one another. Compared to the preoperative heart rate, the heart rate during the intraoperative period was considerably different.
The MAPs during and after surgery were very different.
We suggest further study utilizing larger patient groups and longer follow-up intervals in order to emphasize our results.