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Comparison of vasoconstrictors for functional endoscopic sinus surgery in children
Author(s) -
Riegle Elaine V.,
Gunter Joel B.,
Lusk Rodney P.,
Muntz Harlan R.,
Weiss Karen L.
Publication year - 1992
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-199207000-00012
Subject(s) - oxymetazoline , phenylephrine , medicine , anesthesia , nasal decongestant , heart rate , blood pressure , functional endoscopic sinus surgery , nose , surgery , sinusitis , adrenergic receptor , receptor
Three different vasoconstricting agents were evaluated during functional endoscopic sinus surgery (FESS) in 57 children. Oxymetazoline hydrochloride 0.05%, phenylephrine hydrochloride 0.25%, or cocaine 4% was applied to the nasal mucosa in a prospective, randomized, double‐blind fashion. Heart rate and blood pressure changes were recorded 5 and 10 minutes after application of the study vasoconstrictor to each nostril. The surgeon's subjective impressions of bleeding and visualization were recorded for each side of the nose, as were total blood loss and anesthesia time. Although all three vasoconstrictors were tolerated well by the children, there was a suggestion that heart rate decreased more at 5 minutes with phenylephrine than with oxymetazoline or cocaine ( P = .08) and that blood pressure increased more at 10 minutes with phenylephrine than with oxymetazoline or cocaine ( P = .1). No arrhythmias were noted. Subjective scoring for bleeding showed that children receiving oxymetazoline were less likely to receive scores of “more” bleeding than usual (3/38 vs. 10/34 for phenylephrine and 10/35 for cocaine, P <.02). Subjective scoring for visualization showed that children receiving oxymetazoline were also less likely to receive scores of “worse” visualization than usual (3/38 vs. 12/38 for phenylephrine and 9/35 for cocaine, P <.01). There was no difference in surgical bleeding or visualization between children receiving phenylephrine and children receiving cocaine. In our institution, 0.05% oxymetazoline is the preferred vasoconstrictor for FESS in children.