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We have constructed a patients' response model during endoscopic sinus surgery using local anesthesia. During this surgery, the patient keeps a high level of consciousness, and feels pressure, vibration and pain from the surgical procedures. These feelings affect the patient's mental and physiological condition, and the excessive fluctuation of patient's condition interrupts the surgery. Therefore, awareness of the patient's condition and control of them are important to the surgeon. With this in view, we are constructing a model that can represent the patient's mental and physiological responses. To develop the model, the causal relationship between surgical procedures and patient's responses was investigated. It becomes clear that the patient's response is dependent on the pattern of the procedure sequence, the length of the procedure and the effects resulting from the procedure such as vibration and pain. We constructed a model of these behaviors using the Bayesian network.