The Hemostatic Effect of Desmopressin on Bleeding as a Nasal Spray in Open Septorhinoplasty

Haddady-Abianeh, Shahriar; Rajabpour, Ali; Sanatkar, Mehdi; Farahvash, M J; Khorasani, Ghasemali; Molaei, Hojjat

doi:10.1007/s00266-019-01485-4

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…It is uncertain whether DDAVP improves or worsens total blood loss, because the quality of evidence on this subject is very poor 20 . It has been shown that desmopressin can reduce blood loss during septorhinoplasty 16 . This prospective randomized study evaluated the effect of two different doses of intranasal desmopressin (20 μg and 40 μg) on intraoperative blood loss and the quality of surgical field in FESS compared with placebo.…”

Section: Discussionmentioning

confidence: 99%

“… 20 It has been shown that desmopressin can reduce blood loss during septorhinoplasty. 16 This prospective randomized study evaluated the effect of two different doses of intranasal desmopressin (20 μg and 40 μg) on intraoperative blood loss and the quality of surgical field in FESS compared with placebo. As for LD‐DDAVP, there were no significant intervention effects on the volume of intra‐operative bleeding or clean surgical field rates in endoscopic sinus surgery (effect size d: 0.02, 95% CI: −0.42–0.45 for blood loss; RR: 1.34, 95% CI: 0.86–2.09 for clean surgical field).…”

Section: Discussionmentioning

confidence: 99%

“…The sample size for the study was estimated using G*power, version 3.1.9.2, by taking 5% margin of error and 95% confidence interval. According to Haddady's study, 16 the mean quality of surgical field in the desmopressin and control groups was 4.08 (0.62) and 4.59 (0.76), respectively. The sample size was estimated as 40 patients per group (low‐dose desmopressin, high‐dose desmopressin, and control groups).…”

Section: Methodsmentioning

confidence: 99%

“…According to Haddady's study, 16 the mean quality of surgical field in the desmopressin and control groups was 4.08 (0.62) and 4.59 (0.76), respectively. The sample size was estimated as 40 patients per group (low-dose desmopressin, high-dose desmopressin, and control groups).…”

Section: Sample Sizementioning

confidence: 99%

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Effect of desmopressin on bleeding during endoscopic sinus surgery: A randomized clinical trial

Akbarpour

Jalali

Akbari

et al. 2022

Laryngoscope Investig Oto

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Background This study aimed to evaluate the effect of local nasal desmopressin premedication on blood loss and the quality of surgical field in Functional Endoscopic Sinus Surgery (FESS). Material and methods In a randomized clinical trial, patients referred for FESS to treat their bilateral chronic rhinosinusitis were recruited. The participants were adults (≥18 years). They were randomly assigned (1:1:1) to receive low‐dose (20 μg) or high‐dose (40 μg) intranasal desmopressin (DDAVP) or placebo 60 min before the induction of general anesthesia. Standard FESS was performed by the same surgeon. The primary outcomes were volume of intraoperative bleeding and the quality of surgical field. Clean surgical field was defined as a score ≤2 on the Boezaart grading system. Results A total of 120 patients were included on an intention‐to‐treat basis (mean age: 41.0 years; 40 women, 80 men). There were no significant differences in primary outcomes between low‐dose DDAVP and placebo. As for the volume of blood loss, however, there was a significant difference between high‐dose DDAVP and placebo (mean difference: 29.6 ml; adjusted Cohen's d: −1.02; p < .001). Also, in the high‐dose DDAVP, the probability of having a good surgical field over time was about two times higher than in the placebo group (RRs for first and second surgical sides: 1.89 and 2.18). The number needed to treat for the two time points was 1.6 and 1.3, respectively. Conclusion The present study showed that the use of desmopressin at a dose of 40 μg 1 h before surgery can reduce bleeding and improve the quality of the surgical field. Further studies are recommended to be able to generalize these findings to other ENT surgeries. Level of evidence 1b.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Sample Sizementioning

confidence: 99%

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Effect of desmopressin on bleeding during endoscopic sinus surgery: A randomized clinical trial

Akbarpour

Jalali

Akbari

et al. 2022

Laryngoscope Investig Oto

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“…Tranexamic acid is an anti-fibrinolytic agent and is a safe drug and has no major side effects including thromboembolic events reported in previous studies 10 . Desmopressin is a synthetic anti-diuretic hormone analogue that is useful in the treatment of a wide range of pathologies, including von Willebrand disease and type A hemophilia 11 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effect of Injectable Tranexamic Acid and Inhaled Desmopressin in Controlling Bleeding and Ecchymosis in Open Rhinoplasty

Abianeh

Rahmati²,

Delavari³

et al. 2022

WJPS

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Background: Bleeding during rhinoplasty surgery has a negative effect on the quality of surgery; so, it is important to reduce bleeding during rhinoplasty. We aimed to evaluate the effect of injectable tranexamic acid (TXA) and nasal spray of desmopressin (DDAVP) on reduction in intraoperative bleeding and ecchymosis after open rhinoplasty. Methods: In a Randomized Clinical Trial ( RCT) prepared since 2020 to 2021 in Razi Hospital and Imam Khomeini Hospital, Tehran, Iran on 42 patients who underwent open rhinoplasty were divided into three groups. In the first group, TXA was injected one hour before surgery at a dose of 10 mg / kg with a placebo inhalation spray. In the second group, DDAVP was administered as a nasal spray at a dose of 40 mcg with a placebo injection. The third group received a placebo spray and placebo injection. All required data were gathered and analyzed. Results: In TXA group and DDAVP groups, the volume of bleeding during surgery significantly ( P =0.022) decreased compared to placebo group, also, the quality of the surgical field and the surgeon’s satisfaction significantly ( P =0.007) improved compared to the placebo group but not with each other. Unlike placebo group, there were no reports of postoperative bleeding in the TXA and DDAVP groups. Duration of surgery, ecchymosis on the day after surgery and coagulation tests before and after surgery were not significantly different in three groups. Conclusion: Use of DDAVP and TXA can both reduce the amount of bleeding during surgery and postoperative bleeding in rhinoplasty and improve the quality of the surgical field and the surgeon ‘s satisfaction during surgery.

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Bleeding in Plastic–Aesthetic Surgery: A Prognostic Pathway with Clinical Application

Che

Lyu

2020

Aesth Plast Surg

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The Hemostatic Effect of Desmopressin on Bleeding as a Nasal Spray in Open Septorhinoplasty

Cited by 10 publications

References 9 publications

Effect of desmopressin on bleeding during endoscopic sinus surgery: A randomized clinical trial

Effect of desmopressin on bleeding during endoscopic sinus surgery: A randomized clinical trial

Comparison of the Effect of Injectable Tranexamic Acid and Inhaled Desmopressin in Controlling Bleeding and Ecchymosis in Open Rhinoplasty

Bleeding in Plastic–Aesthetic Surgery: A Prognostic Pathway with Clinical Application

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