Related Experiment Video
Updated: Aug 6, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
The Effect of Phenylephrine Nasal Drops on Surgical Bleeding in Children Underwent Cleft Palate Surgery: A Randomized
Behrooz Zaman1, Masood Mohseni2, Samad Noorizad1
1Department of Anesthesiology and Pain Medicine, Pain Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Insights
Phenylephrine nasal drops significantly reduced bleeding and improved surgical field quality in pediatric cleft palate repair. This intervention offers a safe method for controlling intraoperative bleeding during these procedures.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Craniofacial Surgery
Background:
- Cleft lip and palate are common congenital conditions requiring surgical intervention.
- Effective bleeding control is crucial for successful cleft palate repair surgeries.
- Minimizing blood loss enhances surgical field visualization and patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of phenylephrine nasal drops in reducing intraoperative bleeding during cleft palate repair in children.
- To assess the impact of phenylephrine on surgical field quality and surgeon satisfaction.
Main Methods:
- A controlled, randomized, double-blind clinical trial involving 36 pediatric patients undergoing cleft palate repair.
- Patients were randomized to receive either 0.25% phenylephrine nasal drops or normal saline.
- Bleeding volume, vital signs, surgical field quality, and surgeon satisfaction were meticulously recorded and analyzed.
Main Results:
- No significant differences in hemodynamic parameters (blood pressure, heart rate) were observed between groups.
- A statistically significant reduction in bleeding volume was noted in the phenylephrine group (P = 0.0016).
- Surgeons reported significantly improved surgical field quality and higher satisfaction in the phenylephrine group (P = 0.0068).
Conclusions:
- Nasal phenylephrine drops are effective in reducing bleeding during pediatric cleft palate repair.
- This intervention enhances the surgical field, leading to increased surgeon satisfaction.
- Phenylephrine nasal drops represent a valuable adjunct for hemostasis in cleft palate surgeries.
Background:
Cleft lip and palate are birth defects due to a lack of proper formation of the lip or mouth. Controlling bleeding during cleft lip and palate surgeries is very important.
Objectives:
This study aimed to evaluate the effect of phenylephrine nasal drops on bleeding during and after cleft palate repair surgery in children.
Methods:
This controlled, randomized, double-blind, clinical trial was performed on 36 children aged 6 months to 2 years with cleft palate who were candidates for repair surgery. Patients were randomly divided into 2 groups of 18 patients. In the intervention group, 0.25% phenylephrine drops were poured into the nostrils, and the same amount of normal saline was poured in the control group. Changes in systolic and diastolic blood pressures, heart rate, bleeding during surgery based on the gauzes used, the volume of blood in the suction canister, and the amount of blood in the field, as well as the surgical field quality and surgeon satisfaction, were evaluated using analysis.
Results:
No statistically significant difference was observed between the 2 groups in terms of age, sex, weight, heart rate, and systolic and diastolic blood pressures. The mean volume of bleeding based on the total weight of gauzes used and suctioned blood during surgery showed a statistically significant difference between the intervention and control groups (P = 0.0016). The surgeon satisfaction in terms of the surgical field quality using a 5-point Likert scale showed a significant difference between the 2 groups (P = 0.0068), as well as more satisfaction in the intervention group according to the Boezaart scale (P = 0.0043).
Conclusions:
It seems that the use of nasal phenylephrine drops in pediatric cleft palate surgeries can significantly reduce bleeding and increase the quality of the operation field. Therefore, nasal phenylephrine drops can be used to control bleeding in this type of surgery.
Related Concept Videos
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:27Upper Respiratory Drugs: Decongestants
Most decongestants are readily available over-the-counter in...