Revista Brasileira de Otorrinolaringologia
Print version ISSN 0034-7299
SARMENTO JUNIOR, Krishnamurti Matos de Araujo; TOMITA, Shiro and KOS, Arthur Octavio de Ávila. Topical use of adrenaline in different concentrations for endoscopic sinus surgery. Rev. Bras. Otorrinolaringol. [online]. 2009, vol.75, n.2, pp. 280-289. ISSN 0034-7299. http://dx.doi.org/10.1590/S0034-72992009000200020.
The ideal adrenaline concentration remains unknown. AIM: Compare topical adrenaline solutions in different concentrations. STUDY DESIGN: Prospective, double blind, randomized trial. PATIENTS AND METHODS: 49 patients divided in 3 groups underwent endoscopic sinus surgery, using only topical solutions of adrenaline in different concentrations (1:2,000, 1:10,000 and 1:50,000). We compared the duration of surgery, intra-operative bleeding, plasmatic levels of catecholamines, hemodynamic parameters and changes in heart rhythm. RESULTS: Surgery time was shorter in the group using adrenaline 1:2,000, which also showed less bleeding in all evaluations (objective and subjective - p < 0.0001). Plasmatic levels of epinephrine rose in all groups, more sharply in the 1:2,000 group. There was a trend towards elevation of blood pressure in the groups using adrenaline 1:2,000 and 1:10,000, with a greater occurrence of hypertensive peaks. DISCUSSION: We found a very significance bleeding difference favoring the 1:2,000. The blood pressure elevation in the 1:2,000 and 1:10,000 groups was progressive but very slow throughout the procedure, which could be associated with the anesthesia technique. CONCLUSION: We favor the use of topical adrenalin 1:2,000 due to a clear superiority in hemostasis. Further investigation is needed to corroborate our findings.
Keywords : paranasal sinus diseases; epinephrine; hemostasis surgical; norepinephrine; nasal polyps.