Brief Answer: both have pros and cons Detailed Answer: hello XXXXXXX and welcome to health care magic, I am Dr Sriram XXXXXXX an ENT surgeon and I will try to help you out with your problems. I have performed more than a thousand sinus surgeries and half of them in local and half in general anesthesia. I have found both to be efficient but any day if you are otherwise healthy I would prefer general. However before I urge you to consider any form I would like to list out the pros and cons of both so that you can make an informed decision: Pros: GA -easy to extend surgery -better in case of any complications -good control on different parameters like BP, respiratory rate etc -Patient need not cooperate and will feel nothing LA -Can be done even in complicated cases if you have sufficient experience -less amount of blood loss by my experience (though in GA we can do hypotensive anesthesia which will ensure less bleeding) -faster post op recovery time -less expensive now the cons GA -difficult if any co morbidity like diabetes and hypertension -more expensive (though in many centers it is the same nowadays) -little more recovery time -anesthesia complications though in a simple sinus surgery and in my experience this is very rare LA -patient has to be very co operative -more pain Now coming to the ground level, let me be very straight with you. You must understand that I have done more than five hundred local sinus surgeries extensive case. The only way I could do that is because of co operation from the patient, you must know that it can be quite difficult when you are conscious and there is someone poking your nose even if it is not painful! Of course the fluid and blood which goes into the throat in local surgery can be very well controlled as you will be awake so let that not be a reason to select GA. There is a better reason as enumerated below. I see that you are very paranoid; for such patients I would definitely recommend GA as nowadays it is a very simple procedure and your blood pressure can be very effectively controlled by an experienced anesthetist. In the end it all gets down to your decision and I hope the above points have been able to help you out without confusing you! If you have any more doubts feel free to ask and I would be more than happy to answer them. regards Dr Sriram XXXXXXX

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