Local anaesthetic with vasoconstrictor combinations in septal surgery

McClymont, Leo G.; Crowther, John A.

doi:10.1017/s0022215100106474

Cited by 22 publications

(25 citation statements)

References 8 publications

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“…These agents had been conventionally applied both topically and injected [1]. Infiltration of solutions with adrenaline concentration of 1:100,00-1:200,00 are commonly used while solutions with the concentration of 1:10,000 are commonly used just for topical applications [2,3]. Also infiltration of those agents provide mucoperichondrial flap elevation through hydrodissection in the septal surgery.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Günel

Sarı

Eryılmaz

et al. 2014

Indian J Otolaryngol Head Neck Surg

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Vasoconstrictors agents is used in septal surgery, in attempt to improve haemostasis and thereby improve the surgical field. We aimed to compare the effect of lignocaine with adrenaline injection and alone lignocaine injection with topical adrenalin on perioperative hemodynamic effect, hemorrhage and postoperative pain. Patients undergoing surgery were randomised into two groups: group I in whom infiltration was performed with lignocaine (2 %) with adrenaline (1:100,000), group II in whom infiltration was performed with lignocaine (2 %) injection with topical adrenalin application (1:10,000). The two groups were matched by age, sex, body weight, preanesthesia blood pressure, heart rate, oxygen pressure and hemorrhage. The hemostatic effects postoperative pain in each group were analyzed. No statistically significant differences in operation time, hemodynamic effect, and intraoperative blood loss were reached between the two groups of patients (p [ 0.05). But also group I had significantly better pain scores versus control group in the 2nd, 4th, 6th postoperative hours (p \ 0.05). We suggest that the use of adrenaline infiltration during septal surgery is unnecessary and may subject the patient to the risk of cardiogenic side-effects of systemic absorption.

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Section: Introductionmentioning

confidence: 99%

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Günel

Sarı

Eryılmaz

et al. 2014

Indian J Otolaryngol Head Neck Surg

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“…Vanniasegaram [11] consider in his prospective study of the use of vasoconstrictors versus saline in septal surgery, that there is no benefits of using adrenaline, without dramatic differences in blood loss and operative time between the two groups. McClymont et al [12] consider the using of local anesthetics with vasoconstrictors an optimal combination for septal surgery. In our opinion, the risk of bleeding is higher in non-tumescent rhinoplasty.…”

Section: Discussionmentioning

confidence: 99%

Easy Recognition of Caudal Lower Cartilage Rim Localization for Marginal Incision in Tumescent Rhinoplasty

Candau-Alvarez¹

2017

JOENTR

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Nasal tumescence with local anesthetics is a technique that allows a complete rhinoplasty without the need of general anesthesia, minimizing the bleeding and optimizing the recovery of the patient. Besides these benefits, the natural distorption of the tissues the tumescent solution creates shows new anatomical landmarks, which is the case of a fold that localizes the lower cartilage rim. This fold is not appreciate in non-tumescent rhinoplasty approach. In this article, we discuss the role of tumescent anesthesia to facilitate the dissection of the lower cartilage rim in the marginal approach through this mentioned fold. This easy location made that complete lower cartilage rim dissection can be completed in a significantly reduced time (p=0.001), but it does not decrease the risk of cartilage injury in an experimented hands.

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“…Usually Lidocaine is considered as a vasodilator which should actually increase the bleeding in the operative field. Tatjana and colleagues have studied the bleeding in the operative field during septoplasty [7]. He had shown that infiltration of Lidocaine with adrenaline has reduced the bleeding proving better visibility of surgical field.…”

Section: Pain Scorementioning

confidence: 99%

“…We should remember that Lidocaine is not just a placebo but a drug that can cause toxicity at higher doses [5]. Role of infiltrating various local anesthetic agents in surgeries like tonsillectomy, nasal surgery [6][7][8], tooth extraction [9] etc. were studied before.…”

Section: Introductionmentioning

confidence: 99%

Is Lidocaine Infiltration Really Necessary in Micro Ear Surgeries performed Under General Anaesthesia?

Senthil

Samuel

Ramachandran

2011

Indian J Otolaryngol Head Neck Surg

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To study the role of infiltrating 2% Lidocaine in Micro ear surgeries performed under general anaesthesia. To measure the impact of infiltration of 2% Lidocaine in post operative pain relief and per operative bleeding. A Double blinded, Prospective randomized comparative study was conducted in a tertiary care referral centre. A total of 30 patients planned for micro ear surgeries under general anaesthesia (Tympanoplasty and Cortical mastoidectomy) for CSOM tubotympanic disease were selected and divided into two groups randomly by the chief senior consultant. Group A patients received local infiltration of 2% Lidocaine with one in 200,000 adrenaline and Group B patients received infiltration of one in 200,000 adrenaline in distilled water alone. Operating surgeon assessed the bleeding in the surgical field using Boezaart's grading system. Post operative pain was assessed using a visual analog scale. Pain scores of these patients were assessed in the 1st, 4 and 24th h post operatively and recorded. The mean post operative pain score in the 1st h for the patients in Group A was 0.93 and for patients in Group B was two. The difference in the pain scores between the two groups was significant (P \ 0.02).The difference in the mean post operative pain scores between the two groups in the 4 and 24th h were not significant (P \ 0.1).Per operatively, grade III bleeding was present in 73% of patients in group B and only 33% of patients had grade III bleeding in group A. Infiltration of 2% Lidocaine has a significant impact over the grade of bleeding in the operative field and also on 1st h post operative pain relief. It did not have a significant influence on the pain relief in the 4 and 24th h post operatively.

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Local anaesthetic with vasoconstrictor combinations in septal surgery

Cited by 22 publications

References 8 publications

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Easy Recognition of Caudal Lower Cartilage Rim Localization for Marginal Incision in Tumescent Rhinoplasty

Is Lidocaine Infiltration Really Necessary in Micro Ear Surgeries performed Under General Anaesthesia?

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