Meta‐analysis and literature review of techniques to achieve hemostasis in endoscopic sinus surgery

Brazilian Journal of Anesthesiology

Section: Discussionunclassified

Comparação dos efeitos de sulfato de magnésio e da dexmedetomidina sobre a qualidade da visibilidade em cirurgia endoscópica sinusal: estudo clínico randomizado

Akkaya

Tekelioğlu

Demırhan

et al. 2014

“…Although the vasoconstrictive effect of oxymetazoline is not as powerful as some of these other agents, it has become one of the most commonly used given its favorable safety profile. [4][5][6] Cocaine has been associated with tachycardia, hypertension, and enhancement of the excitatory effects of epinephrine. 7,8 These side effects, coupled with its addictive potential, have led to a decline in the use of cocaine over the past 30 years.…”

mentioning

confidence: 99%

Safety and efficacy of concentrated topical epinephrine use in endoscopic endonasal surgery

Yao

Int Forum Allergy Rhinol

et al. 2015

“…A meta-analysis performed by Khosla et al [26] reviewed comparison of intraoperative blood loss between preoperative steroid-administered and placebo groups. Two studies included in this evaluation concluded that preoperative steroids improved surgical blood loss [22,27].…”

Section: Discussionmentioning

confidence: 99%

Benefit of Preoperative Oral Steroids during Sinus Surgery when Utilizing Concentrated Topical Epinephrine

Yao

et al. 2016

ORL

Background/Aims: Oral steroids have been advocated in the preoperative setting as a means of reducing intraoperative blood loss and surgical time during sinus surgery. The purpose of this study was to analyze the impact of preoperative oral steroid administration on intraoperative bleeding and surgical duration when coupled with concentrated topical epinephrine. Methods: The medical records of 302 patients who underwent bilateral ‘full house' sinus surgery were reviewed. Concentrated topical epinephrine and inhalational anesthesia was used in all patients. Surgical duration and estimated blood loss were compared between the preoperative steroid-exposed and steroid-naive groups. χ² and Student's t tests were used for statistical analysis. Results: One hundred and forty-two patients were exposed to steroid, while the remaining 160 were steroid naive. No significant differences were found with respect to surgical time between the steroid-exposed (96.91 ± 25.97 min) and steroid-naive patients (91.24 ± 32.29 min, p = 0.100). The steroid-exposed group demonstrated a marginally increased blood loss (66.03 ± 55.81 ml) as compared to steroid-naive patients (55.00 ± 38.71 ml, p = 0.048). Conclusion: When coupled with intraoperative concentrated topical epinephrine use, preoperative oral steroid administration provides no clinically significant benefit with respect to reduced intraoperative bleeding or surgical duration.