title: The effect of nasal application of cocaine/adrenaline on blood loss in Le Fort I osteotomies.
abstract: Cocaine is a very potent vasoconstrictor that is used by ENT specialists to reduce blood loss and enhance visibility during nasal surgery. In orthognathic surgery, especially Le Fort I procedures, excessive blood loss is a relatively frequent complication. In this study, a prospective randomized clinical trial on the effect on blood loss of cocaine/adrenaline application to the nasal floor is presented. Thirty patients who underwent a Le Fort I procedure were randomized for cocaine/adrenaline application. Blood loss and duration of surgery were registered for both groups. The results showed a significant reduction of blood loss in the group with cocaine/adrenaline application (P<0.001), but no significant difference in operating time. No side effects were observed. From this study, it can be concluded that the application of cocaine/adrenaline to the nasal floor is a safe procedure to reduce blood loss during a Le Fort I procedure.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Isala Klinieken, Zwolle, The Netherlands. lotte.jan@wxs.nl
authors.forename: J
authors.initials: J
authors.lastname: de Lange
authors.forename: E M
authors.initials: EM
authors.lastname: Baas
authors.forename: R B G
authors.initials: RB
authors.lastname: Horsthuis
authors.forename: A
authors.initials: A
authors.lastname: Booij
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000367:Age Factors; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003042:Cocaine / Q000008:administration & dosage*; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D014663:Nasal Decongestants / Q000008:administration & dosage*; D019340:Osteotomy, Le Fort / Q000009:adverse effects* / Q000379:methods; D013997:Time Factors