Topical cocaine vs adrenaline in endoscopic sinus surgery: a blinded randomized controlled study

Valdés, Constanza J.; Bogado, Mariana; Rammal, Almoaidbellah; Samaha, Mark; Tewfik, Marc A.

doi:10.1002/alr.21325

Cited by 32 publications

(36 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Injectable methods usually involve adrenaline‐containing mixtures injected around the sphenopalatine foramen, the greater palatine foramen and anterior insertion of the middle turbinate. Otolaryngologists advocate different techniques, various injection sites and variable concentrations of adrenaline to reduce surgical bleeding, lessen mucosal congestion and keep clear sight through their direct action on the α ‐adrenergic receptors …”

Section: Discussionmentioning

confidence: 99%

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Saif

Farboud

Delfosse

et al. 2016

Clinical Otolaryngology

View full text Add to dashboard Cite

For operative procedures, such as septorhinoplasty, a single agent tetracaine or levobupivicaine provides an improved surgical field. In functional endoscopic sinus surgery, lidocaine-adrenaline preparations have resulted in significantly better surgical and patient outcomes. There is little evidence to support the routine use of pre-procedural nasal preparation for flexible nasendoscopy. Those undergoing rigid endoscopy conversely always require the use of a vasoconstrictor and local anaesthetic. Pre-procedure assessment of patients is recommended, with agents being reserved for those with low pain thresholds, high anxiety and small nasal apertures presenting resistance to the insertion of the endoscope.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Saif

Farboud

Delfosse

et al. 2016

Clinical Otolaryngology

View full text Add to dashboard Cite

show abstract

“…Beim Einsatz von Imidazolinderivaten sind unbedingt die zulässigen Höchstmengen zu beachten, da insbesondere bei Kindern toxische Reaktionen (kardiovaskulär, zentralnervös) beobachtet wurden [105,106]. Kokain und Adrenalin wirken gleich gut [107]. Einspritzen mit 0,25 % Bupivacain mit Adrenalin 1:200 000 reduziert weder den intraoperativen Blutverlust noch die Operationsdauer, sondern führt zu einem erhöhten mittleren arteriellen Blutdruck [108].…”

Section: Vorbereitung Des Operationsgebietesunclassified

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Weber

2015

Laryngo-Rhino-Otol

View full text Add to dashboard Cite

Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases.Appropriate frame conditions provided, the respective procedures are safe and successful.These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery.The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinusoperation with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus.In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving.This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.

show abstract

“…and Korkmaz et al . also confirm the efficacy with good quality of surgical field with the use of topical epinephrine …”

Section: Discussionmentioning

confidence: 66%

“…12 Studies by Valdes et al and Korkmaz et al 9 also confirm the efficacy with good quality of surgical field with the use of topical epinephrine. 8,23 During ESS, meticulous dissection near numerous vital anatomic areas requires excellent visualization. Even relatively small amounts of uncontrolled bleeding can significantly diminish surgical field visualization.…”

Section: Discussionmentioning

confidence: 99%

The effect of topical epinephrine 1:1000 with and without infiltration of 1% lidocaine with epinephrine 1:100,000 on endoscopic surgical field visualization: a double‐blind randomized controlled study

Tangbumrungtham

Hwang

Maul

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

Background The objective of this study is to determine whether the infiltration of 1% lidocaine with 1:100,000 epinephrine in addition to topical application of 1:1000 epinephrine significantly improves surgical field grading scale score over topical 1:1000 epinephrine alone. Methods A prospective, double‐blind, randomized, controlled study was performed of 40 patients undergoing bilateral endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Patients were enrolled and randomly assigned to receive infiltration with 1% lidocaine with 1:100,000 epinephrine on 1 side of the nasal cavity vs plain saline on the other side in preparation for ESS. Both groups received topical application of 1:1000 epinephrine. Surgical videos were recorded and Wormald surgical field grading scale was assigned by 2 blinded reviewers. The number of extra 1:1000 epinephrine pledgets used during the surgery, estimated blood loss, and surgical duration were also recorded. Results There were no statistically significant differences in Wormald surgical field grading scale, number of extra pledgets used, or estimated blood loss between the nasal cavity side infiltrated with 1% lidocaine with 1:100,000 epinephrine in comparison to infiltration with saline. The side infiltrated with 1% lidocaine with 1:100,000 epinephrine had a reduced operative time compared to the side infiltrated with saline (p = 0.002). There were no differences in postoperative bleeding from questionnaire completed by patient at the first postoperative visit. Conclusion Addition of infiltration of 1% lidocaine with epinephrine 1:100,000 to topical application of epinephrine 1:1000 for preparation of ESS does not significantly improve surgical field of view compared to topical epinephrine alone.

show abstract

Topical cocaine vs adrenaline in endoscopic sinus surgery: a blinded randomized controlled study

Abstract: There is no difference in the quality of the surgical field achieved through the use of topical cocaine or adrenaline during FESS. Either of these agents can be effectively used for topical decongestion at the onset of surgery.

Cited by 32 publications

References 20 publications

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

The effect of topical epinephrine 1:1000 with and without infiltration of 1% lidocaine with epinephrine 1:100,000 on endoscopic surgical field visualization: a double‐blind randomized controlled study

Contact Info

Product

Resources

About