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The effect of intranasal irrigation with epinephrine solution on intraoperative visualization and bleeding during FESS

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

Abstract

Purpose

Bleeding during Functional endoscopic sinus surgery (FESS) can have adverse effect on surgical outcomes. This study evaluates if there is any benefit of adding epinephrine to the saline nasal irrigation in patients undergoing elective FESS for chronic rhinosinusitis.

Methods

A prospective, randomized, double-blinded study was performed. Fifty ASA I or II patients undergoing FESS were randomized to have irrigation either with normal saline or (1:100,000) epinephrine in normal saline during surgery. Outcomes measure included the Boezaart grading scale to assess the intraoperative surgical field, surgeon’s satisfaction with field visualization and bleeding which was evaluated in a 10 cm visual analog scale, estimated blood loss as well as hemodynamic parameters changes.

Results

There was no statistically significant difference in the studied variables between both groups. However in patients with higher than 12 Lund-Mackay score the volume of blood loss was significantly less in the epinephrine group. All surgical procedures were completed and there were no operative complications or any reported perioperative cardiovascular events.

Conclusions

Intraoperative irrigation with saline–epinephrine solution at a concentration of (1:100,000) is safe and does not change heart rate or blood pressure but is unlikely to improve the setting of intraoperative surgical field except for decreasing the volume of blood loss in patients with high Lund-Mackay score.

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Acknowledgements

I thank my colleagues and the nursing staff at King Abdullah University Hospital, Irbid, Jordan, for their kind cooperation and timely help. This work was supported by a grant from deanship of research, Jordan University of Science & Technology, Irbid Jordan.

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Authors and Affiliations

  1. Department of Special Surgery, Division of ORL-HNS, Jordan University of Science and Technology and King Abdullah University Hospital, P. O. Box 3030, Irbid, 22110, Jordan

    Mohannad A. Al-Qudah

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  1. Mohannad A. Al-Qudah
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Correspondence to Mohannad A. Al-Qudah.

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Al-Qudah, M.A. The effect of intranasal irrigation with epinephrine solution on intraoperative visualization and bleeding during FESS. Eur Arch Otorhinolaryngol 279, 1911–1917 (2022). https://doi.org/10.1007/s00405-021-06952-w

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  • DOI: https://doi.org/10.1007/s00405-021-06952-w

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