A Randomized Comparison of Initial Hemodynamic Response Between Three Concentrations of Adrenaline in Lignocaine with Submucosal Infiltration in Septorhinoplasty Patients

Abstract

Objective:To assess the cardiovascular responses induced by different nasal adrenaline-lignocaine mixtures infiltrations protocols for patients undergoing septorhinoplasty under general anesthesia. Methods:Our prospective investigation enrolled 212 subjects, aged 26-34 yrs, classified as physical status class I by the American Society of Anesthesiologists (ASAI), of both sexes and scheduled for septorhinoplasty under general endotracheal anesthesia during the period from January 2010 to December 2012, at the King Hussein Hospital, King Hussein Medical Centre, Amman, Jordan. Patients were divided randomly into three groups. Patients in group A (n=70) received nasal sub mucosal infiltration of 10.2 ml of lignocaine 1% (10 mg/ml) with adrenaline 0.0025% (25 mcg/ml). Subjects in group B (n=72) received 10.2 ml of lignocaine 1% with adrenaline 0.00125% (12.5 mcg mg/ml), while subjects in group C (n=70) received 10.2ml of lignocaine 1% with adrenaline 0.000625% (6.25 mcg/ml). Cardiovascular parameters including heart rate, systolic blood pressure and mean arterial pressure were recorded every half minute during the first 5 minutes after nasal infiltration. Inter-group statistical comparisons were performed using ANCOVA and intra-group statistical comparisons were achieved using ANOVA. Results:In comparison with baseline readings, heart rate was mostly increased, systolic blood pressure was mostly decreased and mean arterial pressure was mostly reduced significantly (P<0.05) at 60 seconds time interval post infiltration in all three groups. Conclusions:Local nasal sub mucosal infiltration of different adrenaline concentrations containing lignocaine solutions could increase heart rate and reduce mean arterial pressure during the first five minutes after infiltration.