Blood loss reduction during laser turbinectomy

The use of a combination of topical and injected anaesthetic and vasoconstrictive agents is widely applied in rhinological practice. To prepare the nose prior to a laser inferior turbinectomy under combined general and local anaesthetic, we routinely spray the nose with 1:1000 epinephrine and inject 2% xylocaine with 1:80.000 epinephrine into each inferior turbinate. With the current climate tending towards evidence based medicine, we were keen to show that our technique of pre-operative nasal preparation was effective. A randomised, double blind, prospective study was carried out, with patients acting as their own control. We found that the injection of 2% xylocaine with 1:80.000 epinephrine did not confer any additional benefit, in terms of blood loss or post-operative pain, in the treatment of these patients. The inferior turbinate that was injected bled more during the procedure than the non-injected side; there was no difference in post-operative discomfort between the 2 sides.