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Updated: Jul 14, 2026
06:13
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Does epinephrine infiltration in septoplasty make any difference? A double blind randomised controlled trial.
Mahilravi Thevasagayam1, Mudit Jindal, Paul Allsop
1Department of Otolaryngology, Queens Hospital NHS Trust, Burton on Trent, Staffordshire, UK.
Summary
Adding epinephrine to lignocaine during septoplasty does not improve surgical outcomes or reduce blood loss. This combination with cocaine paste is not recommended due to potential cardiac risks.
Area of Science:
- Otolaryngology
- Surgical Anesthesia
Background:
- Septoplasty commonly uses lignocaine with epinephrine and cocaine paste to enhance surgical visualization.
- Evidence supporting the efficacy of epinephrine in this combination is lacking.
Observation:
- Thirty patients undergoing septoplasty were randomized into two groups.
- One group received lignocaine with epinephrine infiltration; the control group received lignocaine alone.
- Both groups had pre-operative intranasal cocaine paste application.
Findings:
- No significant difference in blood loss or surgical field quality was observed between the groups.
- A notable increase in systolic blood pressure occurred in the epinephrine group.
- Epinephrine did not improve hemostasis or the surgical field in septoplasty.
Implications:
- The routine use of epinephrine with cocaine paste in septoplasty is not supported by this evidence.
- The combination poses risks, including potential cardiac arrhythmias, and should be avoided.
- Further research may explore alternative methods for improving hemostasis during septoplasty.
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