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Effect of local desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery in patients with chronic rhinosinusitis: a triple-blinded clinical trial

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

Bleeding during functional endoscopic sinus surgery always been a challenge for the quality of surgical field for surgeons. This study aimed to evaluate the effect of local nasal desmopressin premedication on blood loss and the quality of surgical field in functional endoscopic sinus surgery.

Methods

This study was conducted on 90 patients with chronic rhinosinusitis who were candidate for endoscopic sinus surgery. They were randomly assigned to two study groups. One group received a single puff of local desmopressin (10 μg) in each side of nasal cavity 30 min before the surgery and the other received normal saline instead. Blood loss and the quality surgical field were determined in 15, 30, 60 and 90 min during the surgery (scoring by BOEZAART grading system). All data were analyzed.

Results

Blood loss was significantly lesser in the desmopressin group (mean ± SD, 16.289 ± 5.605 ml) than in the control group (24.289 ± 5.2722 ml, P < 0.001).Surgeons were more satisfied with the surgical field in the desmopressin group than control group in all cutoff points (15, 30, 60, and 90 min during the surgery, P < 0.001). No side effects were observed using local desmopressin.

Conclusions

Premedication with local desmopressin can reduce bleeding effectively and clear the surgical field during functional endoscopic sinus surgery.

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References

  1. Chiu A, Kennedy D (2004) Surgical management of chronic rhinosinusitis and nasal polyposis: a review of the evidence. Curr Allergy Asthma Rep 4(6):486–489

    Article  PubMed  Google Scholar 

  2. Kelly EA, Gollapudy S, Riess ML, Woehlck HJ, Loehrl TA, Poetker DM (2013) Quality of surgical field during endoscopic sinus surgery: a systematic literature review of the effect of total intravenous compared to inhalational anesthesia. Int Forum Allergy Rhinol 3(6):474–481

    Article  PubMed  Google Scholar 

  3. Valdes CJ, Al Badaai Y, Bogado M, Samaha M (2014) Does pterygopalatine canal injection with local anaesthetic and adrenaline decrease bleeding during functional endoscopic sinus surgery? J Laryngol Otol 128(9):814–817. https://doi.org/10.1017/S0022215114001790

    Article  CAS  PubMed  Google Scholar 

  4. Mannuccio Mannucci P (2012) Desmopressin (DDAVP) in the treatment of bleeding disorder. Dissertation, World federation of hemophilia. Angelo Bianchi Bonomi Hemophilia and Thrombosis Center IRCCS Cà Granda Maggiore Policlinico Foundation Milan, Italy

  5. IOP Publishing web. https://reference.medscape.com/drug/ddavp-stimate-noctiva-desmopressin-342819.

  6. Guyuron B, Vaughan C, Schlecter B (1996) The role of DDAVP (desmopressin) in orthognathic surgery. Ann Plast Surg 37:516–519

    Article  CAS  PubMed  Google Scholar 

  7. Crescenzi G, Landoni G, Biondi-Zoccai G, Pappalardo F, Nuzzi M, Bignami E (2008) Desmopressin reduces transfusion needs after surgery a meta-analysis of randomized clinical trials. Anesthesiology 109:1063–1076

    Article  CAS  Google Scholar 

  8. Shao H, Kuang L, Hou WJ, Zhang T (2015) Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized clinical trial. BMC Anesthesiol 15:53. https://doi.org/10.1186/s12871-015-0034-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Wormald PJ, Athanasiadis T, Rees G, Robinson S (2005) An evaluation of effect of pterygopalatine fossa injection with local anesthetic and adrenalin in the control of nasal bleeding during endoscopic sinus surgery. Am J Rhinol 19:288–292

    Article  PubMed  Google Scholar 

  10. Rodríguez Valiente A, Roldán Fidalgo A, Laguna Ortega D (2013) Bleeding control in endoscopic sinus surgery: a systematic review of the literature. Rhinology 51:298–305. https://doi.org/10.4193/Rhino12.048

    Article  PubMed  Google Scholar 

  11. Nair S, Collins M, Hung P, Rees G, Close D, Wormald PJ (2004) The effect of β-blocker premedication on the surgical field during endoscopic sinus surgery. Laryngoscope 114(6):1042–1046. https://doi.org/10.1097/00005537-200406000-00016

    Article  CAS  PubMed  Google Scholar 

  12. Nuhi S, Goljanian Tabrizi A, Zarkhah L, Rashedi Ashrafi B (2015) Impact of Intravenous tranexamic acid on hemorrhage during endoscopic sinus surgery. Iran J Otorhinolaryngol 27(82):349–354

    PubMed  PubMed Central  Google Scholar 

  13. Mohseni M, Ebneshahidi A (2011) The effect of oral clonidine premedication on blood loss and the quality of the surgical field during endoscopic sinus surgery: a placebo-controlled clinical trial. J Anesth 25(4):614–617. https://doi.org/10.1007/s00540-011-1157-9

    Article  PubMed  Google Scholar 

  14. Ghorbani J, Arastou Sh, Safavi Naeini A, Raad N, Karimi Galougahi M, Jahangirifard A, Akbari Dilmaghani N (2018) Comparing the effect of oral clonidine and tranexamic acid on bleeding and surgical field quality during functional endoscopic sinus surgery. Iran J Otorhinolaryngol 30(100):255–260

    PubMed  PubMed Central  Google Scholar 

  15. Khoshraftar E, Bakhshaei M H, Shahabinejad M, Porolajal J, Hashemian F (2017) Comparison of the Effects of Magnesium Sulfate and Dexmedetomidine on Operation Field of Candidates for Endoscopic Sinus Surgery. Scientific Journal of Hamadan University of Medical Sciences 24(3):177–182. https://doi.org/10.18869/acadpub.ajcm.24.3.177

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Acknowledgements

This study was supported by research deputy of Hamadan University of medical science, Hamadan, Iran as a thesis of medical specialty. We appreciate Narges Shokri (pharmacist) who performed drugs in similar sprays and coded them.

Funding

This study was funded by research deputy of Hamadan University of medical science, Hamadan, Iran as a thesis of medical specialty.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

    Javaneh Jahanshahi, Elham Tayebi, Farnaz Hashemian & Mohammad Saeid Ahmadi

  2. Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

    Mohammad Hossein Bakhshaei

  3. Department of Community Medicine, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran

    Mohammad Ali Seif Rabiei

Authors
  1. Javaneh Jahanshahi
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  2. Elham Tayebi
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  3. Farnaz Hashemian
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  4. Mohammad Hossein Bakhshaei
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  5. Mohammad Saeid Ahmadi
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  6. Mohammad Ali Seif Rabiei
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Corresponding author

Correspondence to Farnaz Hashemian.

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The authors declare that they have no conflict of interest.

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All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (IR.UMSHA.REC.1396.11) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Jahanshahi, J., Tayebi, E., Hashemian, F. et al. Effect of local desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery in patients with chronic rhinosinusitis: a triple-blinded clinical trial. Eur Arch Otorhinolaryngol 276, 1995–1999 (2019). https://doi.org/10.1007/s00405-019-05435-3

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  • DOI: https://doi.org/10.1007/s00405-019-05435-3

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