Does bismuth subgallate have haemostatic effects in tonsillectomy?

Previous studies have shown that bismuth subgallate added to gauze swabs in tonsillectomy reduces the time to achieve haemostasis and probably reduces the risk of postoperative haemorrhage. All these studies have used bismuth subgallate in combination with adrenaline. In this randomised clinical study we investigated the effect of bismuth subgallate alone. A total of 204 patients were randomised into two groups. One hundred and six patients had swabs with bismuth subgallate. In the control group (n = 98), plain swabs were used. Operating time time to achieve haemostasis, peroperative blood loss, and incidence of postoperative haemorrhages were recorded. There were no significant differences between the two groups. We conclude that the evidence for using bismuth subgallate as a haemostatic agent in tonsillectomy is weak. The effect observed in previous studies can probably be ascribed to the effect of adrenaline.