Plasma Adrenaline Concentrations During Functional Endoscopic Sinus Surgery

Anderhuber, W.; Walch, Christian; Nemeth, Erika; Semmelrock, H. J.; Berghold, Andrea; Ranftl, Günther; Stammberger, Heinz R.

doi:10.1097/00005537-199902000-00006

Cited by 37 publications

(43 citation statements)

References 14 publications

(31 reference statements)

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“…Comparing the results of published papers is difficult, since each deals with different surgical procedures (septoplasty, 2,3,6 turbinectomy, 5 endoscopic surgery of the lateral wall of the nose 4,12 ), a variety of administration methods (submucosa, topical or both 4,6,12,13,14 ), and vasoconstritors (cocaine, adrenalin, phenylephrin, 15 oxymetazoline 12 ). Often these studies tend to associate more than one vasoconstritor, usually adrenaline and cocaine.…”

Section: Discussionmentioning

confidence: 99%

“…21,22 Anderhuber et al studied 51 patients that were given a topical adrenalin 1:1 000 solution associated with submucosal adrenalin 1:200 000 (in patients under fully venous general anesthesia), and found no increases in blood pressure during surgery. 4 Additional controlled studies, preferably with larger series and more homogeneous groups, are needed for more definitive conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…1,4,5 The idea that higher concentrations of adrenalin are needed for improved operability in nasal endoscopic surgery has subtly gained strength. This has been due mostly to the protocols used in health care centers with more experience in endoscopic surgery worldwide, which adopt concentrations for topical use of 1:5 000, 1:2 000 or 1:1 000.…”

Section: Introductionmentioning

confidence: 99%

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Uso tópico da adrenalina em diferentes concentrações na cirurgia endoscópica nasal

Sarmento

Tomita

Kós

2009

Rev. Bras. Otorrinolaringol.

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A concentração ideal de adrenalina tópica a promover hemostasia adequada sem toxicidade ainda é motivo de controvérsia. OBJETIVO: Comparar soluções tópicas de adrenalina em diferentes concentrações. DESENHO DO ESTUDO: Prospectivo, duplo-cego, seleção aleatória. MATERIAIS E MÉTODOS: 49 pacientes submetidos à cirurgia endoscópica nasal, divididos em 3 grupos usando exclusivamente adrenalina tópica, nas concentrações de 1:2000, 1:10.000 e 1:50.000. Comparou-se o tempo operatório, o sangramento, as concentrações plasmáticas de adrenalina e noradrenalina e a variação dos parâmetros cardiovasculares. RESULTADOS: O tempo operatório por procedimento foi menor no grupo que utilizou adrenalina 1:2000, assim como o sangramento (p < 0,0001). As concentrações plasmáticas de adrenalina subiram em todos os 3 grupos, porém mais no grupo que utilizou adrenalina 1:2000. Houve uma tendência de aumento dos níveis tensionais nos pacientes que usaram adrenalina 1:2000 e 1:10.000, com maior ocorrência de picos hipertensivos. Discussão: Os benefícios do uso da solução de adrenalina mais concentrada foram evidentes, principalmente em relação ao sangramento. A tendência de aumento dos níveis tensionais pode ter ocorrido por não termos utilizado técnica anestésica intravenosa exclusiva. CONCLUSÃO: Analisando os prós e contras, sugerimos o uso de solução de adrenalina tópica 1:2000; mais pesquisas que corroborem nossos achados são necessárias.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Uso tópico da adrenalina em diferentes concentrações na cirurgia endoscópica nasal

Sarmento

Tomita

Kós

2009

Rev. Bras. Otorrinolaringol.

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“…10,11,15,19,21 There was no need to remove the middle turbinate in any of our cases, which is aligned with the intention of other groups that always seek to preserve the middle turbinate whenever possible. 16,25,27,30,33,36,38 Topical use of cottonoids with adrenalin at 1:1000 may have helped to locate the ostium of the sphenoidal sinus.51 Intense vasoconstriction and decreased mucosal edema resulting from the use of adrenalin facilitate the approach to the sphenoethmoidal recess without the need to remove the middle turbinate partially or totally.…”

Section: Discussionmentioning

confidence: 99%

“…Topical vasoconstrictor use also has a significant effect for controlling hemorrhage. 38 Kassam et al 42 described a variety of techniques for controlling perioperative bleeding in sellar region endoscopic surgery, and brought attention to the use of hemostatic substances that promote platelet adhesion and clotting. We used one of these products (Spongostan powder®, Johnson & Johnson) in those cases where undesirable sellar region or nasal mucosa bleeding was present in our patients.…”

Section: Discussionmentioning

confidence: 99%

Acesso endoscópico transnasal aos tumores selares

Santos

Zymberg

Filho

et al. 2007

Rev. Bras. Otorrinolaringol.

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Transsphenoi dal surgery for sellar region tumors is traditionally done only by neurosurgeons. The use of endoscopes has permitted a direct transnasal approach to the sphenoidal sinus, without dissection of the septal mucosa, reducing postoperative morbidity. Aim: The purpose of this study was to assess the technical difficulties, and per and postoperative complications of the otolaryngological management of the endoscopic transnasal approach to the sellar region. Material and Method: 159 patients undergoing sellar region surgery between March 2001 and December 2006 were assessed retrospectively. 91 patients who underwent 95 endoscopic transnasal procedures were included in this study. Study design: a clinical retrospective study. Results: The endoscopic transnasal technique was feasible for every patient, independent of age, anatomical variations, tumor characteristics, tumor etiology, and previous surgical history. There was no need to remove the middle turbinate or septal deviations in any of the cases. The most significant peroperative complication was CSF leak during tumor removal (13.68%). Postoperative complications were: nasal bleeding (8.42%), CSF leak (8.42%), and meningitis (2.19). Conclusion: The transnasal endoscopic approach was accomplished with minimal invasion, preserving nasal structures in all 95 procedures, independent of age, anatomical variations, tumor characteristics,tumor etiology, and previous surgical history.

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The Hemostatic and Hemodynamic Effects of Epinephrine During Endoscopic Sinus Surgery

Moshaver¹,

Lin²,

Pinto³

et al. 2009

Arch Otolaryngol Head Neck Surg

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Plasma Adrenaline Concentrations During Functional Endoscopic Sinus Surgery

Abstract: Although systemic absorption of locally injected vasoconstrictors occurs, adrenaline-related side effects during FESS are extremely rare when the patient is monitored exactly.

Cited by 37 publications

References 14 publications

Uso tópico da adrenalina em diferentes concentrações na cirurgia endoscópica nasal

Uso tópico da adrenalina em diferentes concentrações na cirurgia endoscópica nasal

Acesso endoscópico transnasal aos tumores selares

The Hemostatic and Hemodynamic Effects of Epinephrine During Endoscopic Sinus Surgery

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