Hemostasis during functional endoscopic sinus surgery: The effect of local infiltration with adrenaline

Abstract

Topical use of adrenaline achieved similar hemostatic effect compared with injection of adrenaline. Intranasal injection of a vasoconstrictor, in consideration of its adverse effects, may be avoided during surgery.

Hemodynamic Effects of Topical Adrenaline During Septoplasty

“…It has also been reported that acceptable dose of adrenaline may induce cardiac pathology in a patient with no history of coroner artery disease [8]. In addition sometimes cardiologic disorders may not be detected by electrocardiogram or another routine tests [1]. Cardiac arrhythmia is the most seen side effect according to our experience.…”

“…Good visualization is actually critical because the smaller anatomical structure in addition to vascularity in the nose limits access of vision and in many cases a small hemorrhage may reduce completeness in the surgical procedure. Septoplasty surgeon usually use an intranasal injection of the vasoconstrictor to enhance the operative area in the course of septal surgery [1].…”

“…Vasoconstrictors for example adrenaline could possibly have tragic uncomfortable side effects such as cardiomyopathy, cardiac arrhythmia, cardiac arrest, pulmonary edema and central retinal artery occlusion, when applying an intravascular shot in addition to incurring swift systemic intake [1,4]. Intranasal injection causing either rapid uptake as a result of near proximity to body vessel or maybe unrecognized intravascular injection might be the explanation of the exaggerated hemodynamic response in some people.…”

“…Lee et al [1] showed that injection of a adrenaline did not significantly reduce operation time or blood loss when compared with topical application of the adrenaline during functional endoscopic sinüs surgery. They reported that correct use of topical adrenaline pledgets offers both equally surface vasoconstrictive effects and compressional influence on surgical field and may play in an essential role in hemostasis in the surgical treatment.…”

“…Vasoconstrictors agents is used in septal surgery, in attempt to improve haemostasis and thereby improve the surgical field. These agents had been conventionally applied both topically and injected [1]. Infiltration of solutions with adrenaline concentration of 1:100,00-1:200,00 are commonly used while solutions with the concentration of 1:10,000 are commonly used just for topical applications [2,3].…”