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Perioperative Desmopressin for Patients Undergoing Otolaryngologic Procedures: A Systematic Review
Gregory L Barinsky1, David Buziashvili1, Peter F Svider1
11 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Desmopressin (DDAVP) effectively manages bleeding in otolaryngology procedures, acting as both a prophylactic and symptomatic treatment. While generally safe, potential adverse effects like hyponatremia require monitoring.
Area of Science:
- Otolaryngology
- Pharmacology
- Surgical Hemostasis
Background:
- Limited data exists on Desmopressin (DDAVP) use in otolaryngology.
- DDAVP is a hemostatic agent for bleeding disorders.
Purpose of the Study:
- Systematically review DDAVP's use, efficacy, and safety in otolaryngology surgery.
- Provide evidence-based guidance for DDAVP application in this surgical field.
Main Methods:
- Systematic review of PubMed, MEDLINE, and EmBase.
- Assessed study quality using Methodological Index for Non-Randomized Studies and Cochrane bias tool.
- Collected data on patient demographics, DDAVP dosing, and outcomes.
Main Results:
- Nineteen studies (440 patients) analyzed; 16 for prophylaxis, 3 for postoperative use.
- DDAVP demonstrated effectiveness in preventing bleeding and ensuring a dry surgical field.
- 100% success rate for symptomatic use; adverse events included hyponatremia (12.3%), nausea (2.0%), emesis (0.9%), and seizure (0.2%).
Conclusions:
- Current evidence supports DDAVP for perioperative prophylaxis and postoperative bleeding management in otolaryngology.
- DDAVP is effective with minimal adverse events in this setting.
- Further randomized trials are needed to establish definitive guidelines.
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