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Low-dosage adrenaline induces transient marked decrease of blood pressure during functional endoscopic sinus surgery.

Feng Zhao1, Zhongyun Wang, Jianjun Yang

  • 1Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, P.R. China. zhaofeng.nju@163.com

American Journal of Rhinology
|May 12, 2006
PubMed
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Low-dosage adrenaline in local anesthetics causes temporary blood pressure drops during functional endoscopic sinus surgery (FESS). Different adrenaline concentrations did not significantly alter these hemodynamic changes.

Area of Science:

  • Otolaryngology
  • Anesthesiology
  • Cardiovascular Physiology

Background:

  • Adrenaline in local anesthetics is used for hemostasis in functional endoscopic sinus surgery (FESS).
  • Hemodynamic side effects of adrenaline during FESS may be underestimated.
  • A prospective clinical trial investigated these effects.

Purpose of the Study:

  • To evaluate hemodynamic effects of different local anesthetic adrenaline concentrations during FESS.
  • To compare the impact of varying adrenaline dosages on patient hemodynamics.

Main Methods:

  • 108 adult patients undergoing FESS under general anesthesia were randomized into four groups.
  • Groups received different concentrations/dosages of lidocaine with or without adrenaline.
  • Continuous monitoring of heart rate and blood pressure (systolic, diastolic, mean arterial) via radial artery.

Related Experiment Videos

Main Results:

  • Significant decreases in blood pressure (BP) and slight increases in heart rate were observed post-infiltration in groups receiving adrenaline (p < 0.001).
  • No significant hemodynamic changes occurred in the group without adrenaline.
  • No significant differences in hemodynamic changes were found between different adrenaline concentrations.

Conclusions:

  • Low-dose adrenaline in local anesthetics causes temporary, significant hemodynamic changes, notably BP decrease, during FESS.
  • No significant hemodynamic differences exist between adrenaline concentrations of 1:200,000 and 1:400,000 in this context.