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Hemodynamic effects of local anesthetics with adrenaline during septal surgery

Year 2007, Volume: 17 Issue: 3, 127 - 129, 23.05.2007

Abstract

Objectives: We investigated the hemodynamic effects of local anesthetics with adrenaline used before septal surgery.Patients and Methods: İn a prospective, controlled design, administration of local anesthetics was per- formed with and without adrenaline in 39 patients and 10 patients, respectively, undergoing septal surgery. Plasma adrenaline concentrations were measured before anesthesia, and after 2, 5, and 10 minutes from anesthesia. The patients were monitored with respect to pulse rate, electrocardiograph- ic findings, and blood pressure.Results: Preoperative plasma adrenaline levels were similar in patients receiving local anesthetics with or without adrenaline 0.8 nmol/l vs 0.7 nmol/l .Following adrenaline administration, adrenaline lev­ els showed significant increases to 2.2, 1.9, and 1.7 nmol/l after 2, 5, and 10 minutes, respectively p<0.001 , whereas they remained similar in the control group. No side effects related to adrenaline use were detected.Conclusion: Despite systemic absorption of local injections, adrenaline-related side effects during septal surgery are extremely rare when the patients are closely monitored.

References

  • Millar RA, Gilbert RG, Brindle GF. Ventricular tachy- cardia during halothano anaesthesia. Anaesthesia 1958;13:164-72.
  • Rosen M, Roe RB. Adrenaline infiltration during halothane anaesthesia. Br J Anaesth 1963;35:51-3.
  • Varejes L. The use of solutions containing adrenaline dur- ing halothane anaesthesia. Anaesthesia 1963;18:507-10.
  • Savino PJ, Burde RM, Mills RP. Visual loss following intranasal anesthetic injection. J Clin Neuroophthalmol 1990;10:140-4.
  • Millay DJ, Larrabee WF Jr, Carpenter RL. Vasoconstric- tors in facial plastic surgery. Arch Otolaryngol Head Neck Surg 1991;117:160-3.
  • O’Malley TP, Postma GN, Holtel M, Girod DA. Effect of local epinephrine on cutaneous bloodflow in the human neck. Laryngoscope 1995;105:140-3.
  • van Hasselt CA, Low JM, Waldron J, Gibb AG, Oh TE. Plasma catecholamine levels following topical applica- tion versus infiltration of adrenaline for nasal surgery. Anaesth Intensive Care 1992;20:332-6.
  • John G, Low JM, Tan PE, van Hasselt CA. Plasma cat- echolamine levels during functional endoscopic sinus surgery. Clin Otolaryngol Allied Sci 1995;20:213-5.
  • Ashchi M, Wiedemann HP, James KB. Cardiac compli- cation from use of cocaine and phenylephrine in nasal septoplasty. Arch Otolaryngol Head Neck Surg 1995; 121:681-4.
  • Dunlevy TM, O’Malley TP, Postma GN. Optimal con- centration of epinephrine for vasoconstriction in neck surgery. Laryngoscope 1996;106:1412-4.
  • Wanamaker HH, Arandia HY, Wanamaker HH. Epinephrine hypersensitivity-induced cardiovascular crisis in otologic surgery. Otolaryngol Head Neck Surg 1994;111:841-4.
  • Lormans P, Gaumann D, Schwieger I, Tassonyi E. Ventricular fibrillation following local application of cocaine and epinephrine for nasal surgery. ORL J Otorhinolaryngol Relat Spec 1992;54:160-2.
  • Taylor S, Achola K, Smith G. Plasma catecholamine concentrations. The effects of infiltration with local analgesics and vasoconstrictors during nasal opera- tions. Anaesthesia 1984;39:520-3.
  • Derbyshire DR, Chmielewski A, Fell D, Vater M, Achola K, Smith G. Plasma catecholamine responses to tracheal intubation. Br J Anaesth 1983;55:855-60.
  • Low JM, Harvey JT, Cooper GM, Prendiville WJ. Plasma concentrations of catecholamines following adrenaline infiltration during gynaecological surgery. Br J Anaesth 1984;56:849-53.
  • Cotton BR, Henderson HP, Achola KJ, Smith G. Changes in plasma catecholamine concentrations fol- lowing infiltration with large volumes of local anaes- thetic solution containing adrenaline. Br J Anaesth 1986;58:593-7.

Nazal cerrahide adrenalinli lokal anestetiklerin hemodinamik etkileri

Year 2007, Volume: 17 Issue: 3, 127 - 129, 23.05.2007

Abstract

Amaç: Septum cerrahisi öncesi kullanılan adrenalinli lokal anestetiklerin hemodinamik etkileri incelendi.Hastalar ve Yöntemler: İleriye dönük, kontrollü olarak kurgulanan bu çalışmada, septum cerrahisi sırasında submukozal adrenalinli lokal anestetik kullanılan 39 hasta ile adrenalinsiz lokal anestezi uygulanan 10 hastanın plazma adrenalin düzeyleri ölçüldü.Hastalardan anestezi öncesinde ve anestezidensonra 2, 5 ve 10. dakikalarda serum örnekleri alındıve işlem sırasında nabız hızı, elektrokardiyografibulguları ve kan basınçları yakından takip edildi.Bulgular: Ameliyat öncesinde ölçülen adrenalin düzeyi adrenalin kullanılan ve kullanılmayan gruplardabenzerdi 0.8 nmol/l ve 0.7 nmol/l . Adrenalin kullanılan grupta 2, 5 ve 10. dakikalarda ölçülen adrenalin düzeyi ameliyat öncesine göre anlamlı derecedeartış gösterdi sırasıyla, 2.2, 1.9, ve 1.7 nmol/l;p

References

  • Millar RA, Gilbert RG, Brindle GF. Ventricular tachy- cardia during halothano anaesthesia. Anaesthesia 1958;13:164-72.
  • Rosen M, Roe RB. Adrenaline infiltration during halothane anaesthesia. Br J Anaesth 1963;35:51-3.
  • Varejes L. The use of solutions containing adrenaline dur- ing halothane anaesthesia. Anaesthesia 1963;18:507-10.
  • Savino PJ, Burde RM, Mills RP. Visual loss following intranasal anesthetic injection. J Clin Neuroophthalmol 1990;10:140-4.
  • Millay DJ, Larrabee WF Jr, Carpenter RL. Vasoconstric- tors in facial plastic surgery. Arch Otolaryngol Head Neck Surg 1991;117:160-3.
  • O’Malley TP, Postma GN, Holtel M, Girod DA. Effect of local epinephrine on cutaneous bloodflow in the human neck. Laryngoscope 1995;105:140-3.
  • van Hasselt CA, Low JM, Waldron J, Gibb AG, Oh TE. Plasma catecholamine levels following topical applica- tion versus infiltration of adrenaline for nasal surgery. Anaesth Intensive Care 1992;20:332-6.
  • John G, Low JM, Tan PE, van Hasselt CA. Plasma cat- echolamine levels during functional endoscopic sinus surgery. Clin Otolaryngol Allied Sci 1995;20:213-5.
  • Ashchi M, Wiedemann HP, James KB. Cardiac compli- cation from use of cocaine and phenylephrine in nasal septoplasty. Arch Otolaryngol Head Neck Surg 1995; 121:681-4.
  • Dunlevy TM, O’Malley TP, Postma GN. Optimal con- centration of epinephrine for vasoconstriction in neck surgery. Laryngoscope 1996;106:1412-4.
  • Wanamaker HH, Arandia HY, Wanamaker HH. Epinephrine hypersensitivity-induced cardiovascular crisis in otologic surgery. Otolaryngol Head Neck Surg 1994;111:841-4.
  • Lormans P, Gaumann D, Schwieger I, Tassonyi E. Ventricular fibrillation following local application of cocaine and epinephrine for nasal surgery. ORL J Otorhinolaryngol Relat Spec 1992;54:160-2.
  • Taylor S, Achola K, Smith G. Plasma catecholamine concentrations. The effects of infiltration with local analgesics and vasoconstrictors during nasal opera- tions. Anaesthesia 1984;39:520-3.
  • Derbyshire DR, Chmielewski A, Fell D, Vater M, Achola K, Smith G. Plasma catecholamine responses to tracheal intubation. Br J Anaesth 1983;55:855-60.
  • Low JM, Harvey JT, Cooper GM, Prendiville WJ. Plasma concentrations of catecholamines following adrenaline infiltration during gynaecological surgery. Br J Anaesth 1984;56:849-53.
  • Cotton BR, Henderson HP, Achola KJ, Smith G. Changes in plasma catecholamine concentrations fol- lowing infiltration with large volumes of local anaes- thetic solution containing adrenaline. Br J Anaesth 1986;58:593-7.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Alper Ceylan This is me

Fikret İleri This is me

Sabri Uslu This is me

Korhan Asal This is me

Ahmet Ural This is me

Publication Date May 23, 2007
Published in Issue Year 2007 Volume: 17 Issue: 3

Cite

APA Ceylan, A., İleri, F., Uslu, S., Asal, K., et al. (2007). Nazal cerrahide adrenalinli lokal anestetiklerin hemodinamik etkileri. The Turkish Journal of Ear Nose and Throat, 17(3), 127-129.
AMA Ceylan A, İleri F, Uslu S, Asal K, Ural A. Nazal cerrahide adrenalinli lokal anestetiklerin hemodinamik etkileri. Tr-ENT. May 2007;17(3):127-129.
Chicago Ceylan, Alper, Fikret İleri, Sabri Uslu, Korhan Asal, and Ahmet Ural. “Nazal Cerrahide Adrenalinli Lokal Anestetiklerin Hemodinamik Etkileri”. The Turkish Journal of Ear Nose and Throat 17, no. 3 (May 2007): 127-29.
EndNote Ceylan A, İleri F, Uslu S, Asal K, Ural A (May 1, 2007) Nazal cerrahide adrenalinli lokal anestetiklerin hemodinamik etkileri. The Turkish Journal of Ear Nose and Throat 17 3 127–129.
IEEE A. Ceylan, F. İleri, S. Uslu, K. Asal, and A. Ural, “Nazal cerrahide adrenalinli lokal anestetiklerin hemodinamik etkileri”, Tr-ENT, vol. 17, no. 3, pp. 127–129, 2007.
ISNAD Ceylan, Alper et al. “Nazal Cerrahide Adrenalinli Lokal Anestetiklerin Hemodinamik Etkileri”. The Turkish Journal of Ear Nose and Throat 17/3 (May 2007), 127-129.
JAMA Ceylan A, İleri F, Uslu S, Asal K, Ural A. Nazal cerrahide adrenalinli lokal anestetiklerin hemodinamik etkileri. Tr-ENT. 2007;17:127–129.
MLA Ceylan, Alper et al. “Nazal Cerrahide Adrenalinli Lokal Anestetiklerin Hemodinamik Etkileri”. The Turkish Journal of Ear Nose and Throat, vol. 17, no. 3, 2007, pp. 127-9.
Vancouver Ceylan A, İleri F, Uslu S, Asal K, Ural A. Nazal cerrahide adrenalinli lokal anestetiklerin hemodinamik etkileri. Tr-ENT. 2007;17(3):127-9.