Cardiovascular Effects and Efficacy of a Hemostatic Agent in Periradicular Surgery

Abstract

The purpose of this study was to evaluate the hemostatic efficacy and systemic cardiovascular effects of CollaCote collagen sponges saturated with 2.25% racemic epinephrine during endodontic surgery. A total of 48 patients participated in the study. Patients received CollaCote-saline or CollaCote-epinephrine placed in the bony crypt, after which hemostatic efficacy was evaluated. Blood pressure and pulse rate was recorded before and after administration of the local anesthetic, after the application of the test solutions, and before the patient's dismissal. Results showed no significant difference in blood pressure or pulse rate between the experimental and control groups. In the CollaCote-saline group, five of six cases failed to achieve hemorrhage control. In the CollaCote-epinephrine group, 1 of 42 cases had no hemorrhage control. Two patients had slight but apparent intermittent bleeding. Complete hemostasis was achieved in 39 of 42 cases. In conclusion, the results suggest that CollaCote collagen sponges saturated with 2.25% racemic epinephrine provide excellent hemostasis with no evident changes in blood pressure or pulse rate.

Retrospective Evaluation of Surgical Endodontic Treatment: Traditional versus Modern Technique

“…In the modern technique local anesthesia with epinephrine 1:50,000 and cotton pellets with epinephrine were used to improve hemostasis. Concern has been expressed about fibers from cotton pellets that may impair root-end seal or serve as foreign bodies in the surgical site (24). Vy et al (24) successfully used resorbable CollaCote collagen sponges saturated with racemic epinephrine with no evidence of cardiovascular changes.…”

Modern Endodontic Surgery Concepts and Practice: A Review

“…Once an incision has been made and the flap is reflected, topical hemostats, in many situations, play an important role in achieving hemostasis. They can be broadly classified by their mechanism of action (32):…”

Hemostatic Agents in Periapical Surgery: A Randomized Study of Gauze Impregnated in Epinephrine versus Aluminum Chloride

“…judged the initial and final bleeding and recorded it as adequate or inadequate. On the basis of Vy et al (3) and Azargoon et al (7), adequate hemostasis was defined as complete hemorrhage control, providing a dry surgical field, and inadequate hemostasis was defined as slight but apparent intermittent bleeding that persisted after application of the material. The surgeon recorded the value at the time of the surgery, and the bony crypts were photographed (Canon EOS 70D, Canon Macro Ring Lite MR-14EX, Canon EF 100 mm f/2.8 Macro USM; Tokyo, Japan) before the application and after the removal of the hemostatic agents for the record of the 2 independent examiners.…”

“…It has been more than 10 years since Vickers et al (2) and Vy et al (3) published comparative studies; the first compared epinephrine pellets and 20% ferric sulfate, and both agents produced adequate hemostasis. Vy et al suggested that CollaCote (collagen sponges) saturated with 2.25% racemic epinephrine provide excellent hemostasis compared with those saturated with saline.…”