title: Bismuth subgallate-epinephrine paste in adenotonsillectomies.
abstract: OBJECTIVE
  To evaluate the role of bismuth subgallate-epinephrine (BSE) paste as a hemostatic in adenotonsillectomies.
  
  
  METHODS
  MEDLINE (January 1966-October 1999) and Current Contents (January 1997-October 1999) were searched, using bismuth subgallate, adenoidectomy, tonsillectomy, and adenotonsillectomy as search terms. A citation search was performed using Science Citation Index (January 1977-October 1999).
  
  
  RESULTS
  Adenotonsillectomies are common procedures; although there are few complications, hemorrhage is a concern. Bismuth subgallate has historically been used as an astringent and hemostatic. An evaluation of studies of bismuth subgallate and BSE paste was conducted.
  
  
  CONCLUSIONS
  There is minimal evidence to support this practice, but data suggest that epinephrine may be the active ingredient in BSE paste. BSE paste is inexpensive, poses little risk, and may decrease postoperative bleeding; therefore, it may be a reasonable hemostatic agent.
authors.affiliation: Drug Information and Pharmacy Resource Center, Shands at the University of Florida, Gainesville 32610, USA. hatton@shands.ufl.edu
authors.forename: R C
authors.initials: RC
authors.lastname: Hatton
mesh_terms: D002986:Clinical Trials as Topic; D004837:Epinephrine / Q000627:therapeutic use*; D005707:Gallic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D009942:Organometallic Compounds / Q000627:therapeutic use*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D014068:Tonsillectomy / Q000009:adverse effects
chemical_list: D006490:Hemostatics; D009942:Organometallic Compounds; D005707:Gallic Acid; C002170:bismuth subgallate; D004837:Epinephrine