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Summary
High-concentration ornipressin with lidocaine provides effective haemostasis in rhinosurgery under halothane/enflurane anesthesia. However, it may cause blood pressure elevation under diazepam/fentanyl anesthesia, limiting its use in patients with blood pressure dyscrasias.
Area of Science:
- Anesthesiology
- Otolaryngology
- Pharmacology
Background:
- Ornipressin is used for its vasoconstrictive properties to achieve haemostasis.
- High concentrations of ornipressin (5 IU/10 mls) with lidocaine were investigated for surgical bleeding control.
- The study evaluated the haemostatic efficacy and safety of ornipressin under different anaesthetic conditions.
Purpose of the Study:
- To assess the haemostatic effect of high-concentration ornipressin with lidocaine during rhinosurgery.
- To compare the effects of ornipressin on blood pressure and heart rate under two distinct general anaesthesia regimens.
- To determine the suitability of this ornipressin concentration for patients with varying physiological states.
Main Methods:
- A study involving 127 patients undergoing rhinosurgery.
- Local injection of ornipressin (5 IU/10 mls) with lidocaine into nasal tissues.
- Comparison of outcomes under halothane/enflurane anaesthesia versus diazepam/fentanyl anaesthesia.
Main Results:
- Under halothane/enflurane anaesthesia, blood pressure and heart rate remained stable, with 86.5% achieving good haemostasis.
- Under diazepam/fentanyl anaesthesia, ornipressin infiltration led to blood pressure elevation.
- Good haemostasis was achieved in only 60% of patients under diazepam/fentanyl anaesthesia.
Conclusions:
- High-concentration ornipressin with lidocaine is effective for haemostasis in rhinosurgery under halothane/enflurane anaesthesia.
- The combination is not recommended for patients with blood pressure dyscrasias due to potential adverse effects under diazepam/fentanyl anaesthesia.
- Careful consideration of anaesthetic type is crucial when using ornipressin for surgical haemostasis.