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Topical use of adrenaline in different concentrations for endoscopic sinus surgery
Krishnamurti Matos de Araujo Sarmento Junior1, Shiro Tomita, Arthur Octavio de Avila Kós
1Otorhinolaryngology, UFRJ.
Unlabelled:
The ideal adrenaline concentration remains unknown.
Aim:
Compare topical adrenaline solutions in different concentrations.
Study Design:
Prospective, double blind, randomized trial.
Patients And Methods:
49 patients divided in 3 groups underwent endoscopic sinus surgery, using only topical solutions of adrenaline in different concentrations (1:2,000, 1:10,000 and 1:50,000). We compared the duration of surgery, intra-operative bleeding, plasmatic levels of catecholamines, hemodynamic parameters and changes in heart rhythm.
Results:
Surgery time was shorter in the group using adrenaline 1:2,000, which also showed less bleeding in all evaluations (objective and subjective - p < 0.0001). Plasmatic levels of epinephrine rose in all groups, more sharply in the 1:2,000 group. There was a trend towards elevation of blood pressure in the groups using adrenaline 1:2,000 and 1:10,000, with a greater occurrence of hypertensive peaks.
Discussion:
We found a very significance bleeding difference favoring the 1:2,000. The blood pressure elevation in the 1:2,000 and 1:10,000 groups was progressive but very slow throughout the procedure, which could be associated with the anesthesia technique.
Conclusion:
We favor the use of topical adrenalin 1:2,000 due to a clear superiority in hemostasis. Further investigation is needed to corroborate our findings.
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