Comparative Study between Greater Palatine Canal Injection by Epinephrine and Conventional Method on Intraoperative Bleeding during Endoscopic Sinus Surgery

Document Type : Original Article

Authors

1 Department of Otorhinlaryngology faculty of medicine Beni-Suef University

2 Otorhinlaryngology department, faculty of medicine, Beni-Suef University.

3 Resident in Minia General Hospital in Minia, Ministry of health

4 Department of Otorhinlaryngology , faculty of medicine, Beni-Suef University

Abstract

Aim: This study aimed to compare between the effectiveness among GPC injection by epinephrine and conventional method of lateral nasal wall injection by epinephrine in reducing surgical field bleeding and decreasing surgical time under hypotensive general anaesthesia during ESS.
Patients and methods: After ethical approval, this comparative, prospective double blinded randomized controlled trial was done in Otorhinolaryngology department in Beni-Suef University from October 2019 to April 2021 on patients diagnosed with bilateral CRS or bilateral sinonasal polyposis unresponsive to medical treatment hospital to undergo endoscopic sinus surgery. The study included 40 patients Group (A) underwent Conventional injection and Group (B) GPC injection (opposite side).
Results: The total amount of blood was significantly higher among group (A) than group (B) subjects with mean (190.9 ± 44.5) ml versus (117.33 ± 26.4) ml respectively, (P-value 0.001). Surgical time was significantly more among group (A) than group (B) with a mean equal to (54.88 ± 7.7) minutes versus (35.78 ± 4.47) minutes respectively, (P-value 0.001). Bleeding grade was significantly higher among group (A) than group (B). SBP and DBP was lower among group (B) than group (A) at t 15, 30, 45 minutes.
Conclusion: No hemodynamic instability and no serious complications were observed with this simple technique of GPC injection method. Based on these current findings, GPC injection is efficient, safe and simple proposed approach along with hypotensive general anaesthesia for optimizing surgical field, reducing intraoperative bleeding, operative time and increasing surgeon satisfaction during ESS.

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