title: Topical use of adrenaline in different concentrations for endoscopic sinus surgery.
abstract: The ideal adrenaline concentration remains unknown.
  
  
  OBJECTIVE
  Compare topical adrenaline solutions in different concentrations.
  
  
  METHODS
  Prospective, double blind, randomized trial.
  
  
  METHODS
  49 patients divided in 3 groups underwent endoscopic sinus surgery, using only topical solutions of adrenaline in different concentrations (1:2,000, 1:10,000 and 1:50,000). We compared the duration of surgery, intra-operative bleeding, plasmatic levels of catecholamines, hemodynamic parameters and changes in heart rhythm.
  
  
  RESULTS
  Surgery time was shorter in the group using adrenaline 1:2,000, which also showed less bleeding in all evaluations (objective and subjective - p < 0.0001). Plasmatic levels of epinephrine rose in all groups, more sharply in the 1:2,000 group. There was a trend towards elevation of blood pressure in the groups using adrenaline 1:2,000 and 1:10,000, with a greater occurrence of hypertensive peaks.
  
  
  CONCLUSIONS
  We found a very significance bleeding difference favoring the 1:2,000. The blood pressure elevation in the 1:2,000 and 1:10,000 groups was progressive but very slow throughout the procedure, which could be associated with the anesthesia technique.
  
  
  CONCLUSIONS
  We favor the use of topical adrenalin 1:2,000 due to a clear superiority in hemostasis. Further investigation is needed to corroborate our findings.
authors: Otorhinolaryngology, UFRJ.
authors: Krishnamurti Matos de Araujo
authors: KM
authors: Sarmento Junior
authors: Shiro
authors: S
authors: Tomita
authors: Arthur Octavio de Avila
authors: AO
authors: Kós
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D002395:Catecholamines / Q000097:blood; D004311:Double-Blind Method; D004724:Endoscopy / Q000379:methods*; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006439:Hemodynamics; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D002395:Catecholamines; D014662:Vasoconstrictor Agents; D004837:Epinephrine