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Related Experiment Videos

Plasma catecholamine levels during functional endoscopic sinus surgery

G John1, J M Low, P E Tan

  • 1Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital.

Clinical Otolaryngology and Allied Sciences
|June 1, 1995
PubMed
Summary
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Functional endoscopic sinus surgery (FESS) patients experienced a significant increase in plasma adrenaline after local anesthetic infiltration. This systemic absorption of vasoconstrictors is unpredictable and necessitates careful patient monitoring during procedures.

Area of Science:

  • Anesthesiology
  • Otolaryngology
  • Pharmacology

Background:

  • Functional endoscopic sinus surgery (FESS) often involves local anesthetics with vasoconstrictors.
  • Systemic absorption of these agents can lead to cardiovascular effects.
  • Understanding the pharmacokinetic profile of these infiltrates is crucial for patient safety.

Purpose of the Study:

  • To measure plasma adrenaline and noradrenaline concentrations in patients undergoing FESS.
  • To assess the systemic absorption of locally infiltrated vasoconstrictors during FESS.
  • To highlight the potential risks associated with these procedures.

Main Methods:

  • Plasma samples were collected from 10 consecutive patients during FESS.
  • Nasal packing with cocaine solution preceded infiltration with adrenaline and lignocaine.

Related Experiment Videos

  • Plasma adrenaline and noradrenaline levels were analyzed.

    • Main Results:

    • All patients exhibited a significant increase in plasma adrenaline within 4 minutes of infiltration.
    • The rise in adrenaline was independent of patient demographics, injected volume, or site.
    • Noradrenaline levels were not explicitly mentioned in the provided text, but adrenaline surge was significant.

    Conclusions:

    • Local infiltration of vasoconstrictors during FESS leads to marked and unpredictable systemic adrenaline absorption.
    • Surgeons must be aware of this risk, even under local anesthesia.
    • Mandatory pulse and electrocardiogram (ECG) monitoring is recommended for FESS procedures.