Topical use of adrenaline in different concentrations for endoscopic sinus surgery.
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.
Sarmento Junior
Krishnamurti Matos de Araujo
KM
Otorhinolaryngology, UFRJ.
Tomita
Shiro
S
Kós
Arthur Octavio de Avila
AO
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
D002395:Catecholamines; D014662:Vasoconstrictor Agents; D004837:Epinephrine