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Infiltration of epinephrine in tonsillectomy: a randomized, prospective, double-blind study
B M Rasgon1, R M Cruz, R L Hilsinger
1Department of Otolaryngology, Kaiser Permanente Medical Center, Oakland, CA 94611-5693.
The Laryngoscope
|February 11, 1991
Summary
Epinephrine injection significantly reduces blood loss and dissection time during tonsillectomy compared to normal saline. This study found epinephrine safe and effective for reducing surgical bleeding in tonsillectomy procedures.
Area of Science:
- Otolaryngology
- Surgical Hemostasis
- Anesthesiology
Background:
- Tonsillectomy often involves significant blood loss.
- Existing hemostatic agents lack robust clinical evidence.
- Need for objective data on hemostatic techniques in tonsillectomy.
Purpose of the Study:
- To evaluate the efficacy of epinephrine in reducing intraoperative blood loss during tonsillectomy.
- To compare epinephrine with normal saline as a local injection for tonsillectomy.
- To assess the safety and impact on dissection time and postoperative bleeding.
Main Methods:
- Randomized, prospective, double-blind study with patients as their own controls.
- Ninety-two patients received normal saline in one tonsil and 1:100,000 epinephrine in the other prior to tonsillectomy.
- Blood loss, dissection time, postoperative bleeding, and cardiac manifestations were recorded for each tonsil.
Main Results:
- Epinephrine injection led to a statistically significant reduction in blood loss and dissection time compared to normal saline.
- Subjective assessment indicated easier dissection on the epinephrine-injected side.
- No significant difference in postoperative hemorrhage incidence was observed; cardiac effects were minimal and transient.
Conclusions:
- Epinephrine is an effective and safe agent for reducing hemorrhage during tonsillectomy.
- The use of epinephrine with appropriate inhalation anesthetics is supported by this study.
- Objective data confirms the hemostatic benefits of epinephrine in tonsillectomy.