title: Epinephrine Injection in Greater Palatine Canal: An Alternative Technique for Reducing Hemorrhage During Septoplasty.
abstract: OBJECTIVE
  Obtaining adequate hemostasis during otolaryngology operations is necessary because a small amount of blood can be problematic and obscure the visual field. The authors aimed to compare the efficacy of combined greater palatine canal (GPC) and transnasal injection of lidocaine + epinephrine to transnasal injection alone in patients who underwent septoplasty.
  
  
  METHODS
  Patients with nasal septum deviation who were eligible for surgical correction of deviations were enrolled. Transnasal injections of 2 mL of 1% lidocaine + epinephrine 1:100,000 were performed in both groups and for patients in the combination group the same solution was also injected in the GPC. Objective (amount of suctioned blood) and subjective (intraoperative bleeding score) assessments were done during operation. Close hemodynamic monitoring was performed for all patients.
  
  
  RESULTS
  A total of 50 patients were enrolled and randomly allocated to study groups. No significant differences were observed in systolic and diastolic blood pressure, heart rate, and mean arterial pressure of study subjects between 2 groups. The amount of bleeding in patients who received GPC injection and their counterparts in the other arm of the trial were 34.64 ± 26.66 and 100.48 ± 20.90 mL, respectively (P < 0.001). The mean intraoperative bleeding score in combination group was 0.79 ± 0.42 and significantly lower than the corresponding figure in monotherapy group, which was 1.75 ± 0.41 (P < 0.001).
  
  
  CONCLUSIONS
  Based on the findings of the current study, the authors suggest that combined GPC and transnasal injection of lidocaine and epinephrine is a safe and effective method for reducing bleeding during septoplasty.
authors.affiliation: *Otorhinolaryngology Research Center †School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dadgarnia
authors.forename: Honeyeh
authors.initials: H
authors.lastname: Shahbazian
authors.forename: Nasim
authors.initials: N
authors.lastname: Behniafard
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Baradaranfar
authors.forename: Saeid
authors.initials: S
authors.lastname: Atighechi
authors.forename: Vahid
authors.initials: V
authors.lastname: Zand
authors.forename: Sanaz
authors.initials: S
authors.lastname: Zand
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006489:Hemostatic Techniques; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D009666:Nose; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine