Plasma catecholamine levels during functional endoscopic sinus surgery

John, Gregor; Low, J. M.; Tan, Perpetua E.; Hasselt, C. Andrew van

doi:10.1111/j.1365-2273.1995.tb01850.x

Cited by 36 publications

(42 citation statements)

References 6 publications

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“…On the other hand, frequent using these types of agencies bring about problems for example gastrointestinal irritability, tendency to bleed, in addition to allergy symptoms, that might reduce their use [12]. John et al [13] reported that infiltration technique is better than surface anesthesia in pain control but there was no difference in blood loss between two technique. Temple et al [9] demonstrated that there were no difference in pain after turbinectomy between topical adrenaline applying and injecting adrenaline and xylocaine.…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…Often these studies tend to associate more than one vasoconstritor, usually adrenaline and cocaine. 14,16 In our view, not enough information is available about the behavior of each vasoconstritor singly on the nasal mucosa; thus, such associations are not beneficial for research purposes, since they complicate data analysis. This is the first paper that we know of comparing adrenalin solutions (not associated with other vasoconstritors) used only topically on the nasal mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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“…Injected vasoconstrictors can lead to serious side effects. After injection of lignocaine with adrenaline, plasma levels of adrenaline reach a peak value that is highly variable and not related to the amount injected into the nasal mucosa [18]. Also, with topical anesthesia with cocaine, idiosyncratic absorption can occur.…”

Section: Discussionmentioning

confidence: 99%

Metoprolol Significantly Improves Visual Clarity and Hemodynamic Parameters during Functional Endoscopic Sinus Surgery

2019

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Background and Objectives: The success of functional endoscopic sinus surgery (FESS) depends on the visual clarity of the surgical field, which is understudied. Controlled hypotension has many advantages for FESS including reduction in blood loss and improved quality of the surgical field. This study determined whether the use of β-blockers as a premedication could improve the operative field in FESS. Methods: Sixty patients aged from 18 to 50 years, undergoing septoplasty and FESS were included in this prospective, randomized, double-blind, placebo-controlled study. Patients were randomly assigned to receive either metoprolol (100 mg, group 1) or a placebo (a vitamin tablet, group 2) 60 min before surgery. Results: The average blood loss and surgery duration were not significantly higher in the placebo group. The surgical field was graded using the Fromme-Boezaart scale, and it was significantly clearer (p < 0.001) in metoprolol group. The mean arterial blood pressure was significantly lower in the metoprolol group after 30 min of induction until the end of surgery (p < 0.001). The heart rate was also significantly lower (p < 0.001) in those who received metoprolol from before induction of anesthesia up to the end of surgery. Conclusion: Metoprolol significantly improves visual clarity and hemodynamics during FESS. We would recommend the use of metoprolol in FESS and septoplasty.

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Plasma catecholamine levels during functional endoscopic sinus surgery

Cited by 36 publications

References 6 publications

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Uso tópico da adrenalina em diferentes concentrações na cirurgia endoscópica nasal

Metoprolol Significantly Improves Visual Clarity and Hemodynamic Parameters during Functional Endoscopic Sinus Surgery

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