Effect of gauze placement soaked with adrenaline at suprabullar recess on hemostasis during endoscopic sinus surgery: A randomized controlled trial

Head Neck. 2020 Sep;42(9):2397-2404. doi: 10.1002/hed.26243. Epub 2020 May 9.

Abstract

Background: Topical application of vasoconstrictors is necessary for endoscopic sinus surgery (ESS) for a bloodless surgical view and reduced intraoperative bleeding. We aimed to verify the effectiveness of gauze placement soaked with adrenaline at suprabullar recess, where the anterior ethmoidal artery exists, on hemostasis during ESS.

Methods: A randomized, double-blinded trial was carried out for 26 patients receiving ESS. At the beginning of the surgery, gauze soaked with 2% lidocaine with or without 1:10 000 adrenaline was placed at the suprabullar recess for 8 minutes. Estimated blood loss, surgical field score, and operation time were compared between the two groups.

Results: Estimated blood loss and surgical field score were significantly smaller in the adrenaline group than in the no adrenaline group. Operation time was not significantly different between the two groups.

Conclusion: Gauze placement soaked with adrenaline at suprabullar recess reduces estimated blood loss and clears the surgical field during ESS.

Keywords: blood loss; endoscopic sinus surgery; epistaxis; hemostasis; paranasal sinuses.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Bandages*
  • Endoscopy
  • Epinephrine* / administration & dosage
  • Hemostasis*
  • Humans
  • Lidocaine
  • Paranasal Sinuses* / surgery
  • Vasoconstrictor Agents* / administration & dosage

Substances

  • Vasoconstrictor Agents
  • Lidocaine
  • Epinephrine