Hemostasis during functional endoscopic sinus surgery: the effect of local infiltration with adrenaline.

OBJECTIVES To determine the feasibility of the use of a topical vasoconstrictor for hemostasis during functional endoscopic sinus surgery. STUDY DESIGN Case-control study. SUBJECTS AND METHODS From May 1998 to August 2002, 226 patients (injection group) with bilateral chronic rhinosinusitis received an adrenaline injection for hemostasis during functional endoscopic sinus surgery at our tertiary referral center. After September 2002, topical adrenaline was applied for hemostasis in 226 consecutive patients (noninjection group) who underwent the same surgery. The two groups were matched by age, sex, body weight, stage of chronic rhinosinusitis, and pre-anesthesia blood pressure. The hemostatic effects in each group were analyzed. RESULTS No statistically significant differences in operation time and intraoperative blood loss were reached between the two groups of patients. CONCLUSIONS Topical use of adrenaline achieved similar hemostatic effect compared with injection of adrenaline. Intranasal injection of a vasoconstrictor, in consideration of its adverse effects, may be avoided during surgery.