Blood loss reduction during laser turbinectomy

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Anesthesia

Background:

• Topical and injected anesthetic and vasoconstrictive agents are common in rhinological practice.
• Preoperative nasal preparation is crucial for procedures like laser inferior turbinectomy.

Purpose of the Study:

• To evaluate the effectiveness of routinely used pre-operative nasal preparation for laser inferior turbinectomy.
• To determine if injecting xylocaine with epinephrine into inferior turbinates reduces blood loss or post-operative pain.

Main Methods:

• A randomized, double-blind, prospective study was conducted.
• Patients served as their own controls, comparing injected versus non-injected inferior turbinates.
• Laser inferior turbinectomy was performed under combined general and local anesthesia.

Main Results:

• Injecting 2% xylocaine with 1:80,000 epinephrine did not provide additional benefits regarding blood loss or post-operative pain.
• The injected inferior turbinate exhibited increased bleeding during the procedure compared to the non-injected side.
• No significant difference in post-operative discomfort was observed between the two sides.

Conclusions:

• Routine pre-operative injection of xylocaine with epinephrine into inferior turbinates is not beneficial for laser turbinectomy.
• The practice may lead to increased intraoperative bleeding without improving patient outcomes.
• Evidence-based evaluation suggests reconsidering this standard preparation technique.