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Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis

Year 2025, Volume: 8 Issue: 3, 122 - 125, 23.12.2025
https://doi.org/10.65396/ejra.1838060
https://izlik.org/JA67LH67HN

Abstract

INTRODUCTION
Acute sinusitis is a common inflammatory condition of the paranasal sinuses characterized by facial pain, nasal obstruction, and mucopurulent discharge. Topical nasal decongestants and local anesthetics are routinely used to achieve symptomatic relief. This study evaluates the therapeutic efficacy and safety of topical adrenaline and lignocaine applied to the middle meatus in patients with bilateral acute maxillary sinusitis.

MATERIALS AND METHODS
A prospective, randomized controlled trial was conducted on 100 adult patients diagnosed with bilateral acute maxillary sinusitis. Patients were randomly allocated into two groups. Group A (n=50) received a cotton pledget soaked in 2 ml of 4% lignocaine with 1:10,000 adrenaline, while Group B (n=50) received normal saline pledgets. Subjective outcomes were assessed using the Visual Analog Scale (VAS) for pain, nasal obstruction, and discharge, along with endoscopic evaluation of mucosal edema and pus clearance. Assessments were performed at baseline, 1 hour, and 24 hours post-intervention. Hemodynamic parameters and adverse events were monitored.

OBSERVATIONS & RESULTS
Baseline demographic and clinical characteristics were comparable between groups. Group A demonstrated significantly greater improvement in pain scores at 1 hour and 24 hours (p<0.001). Endoscopic findings showed superior resolution of mucosal edema, pus clearance, and middle meatal patency in Group A. Mild and transient adverse effects were noted in a few patients, with no serious complications.

CONCLUSION
Topical application of 4% lignocaine with 1:10,000 adrenaline in the middle meatus provides rapid, safe, and effective symptomatic relief in acute maxillary sinusitis and may reduce dependence on prolonged medical therapy.

References

  • 1. Ah-See K. Sinusitis (acute). BMJ Clin Evid. 2008 Mar 10;2008:0511.
  • 2. Dasaraju PV, Liu C. Infections of the Respiratory System. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 93. Available from: https://www.ncbi.nlm.nih.gov/books/NBK8142/
  • 3. Masood A, Moumoulidis I, Panesar J. Acute rhinosinusitis in adults: an update on current management. Postgrad Med J. 2007 Jun;83(980):402-8.
  • 4. Friedlander S. Acute rhinosinusitis--does quality of life explain continued rates of antibiotic overusage? Prim Care Respir J. 2012 Jun;21(2):130-1.
  • 5. Min HK, Lee S, Kim S, Son Y, Park J, Kim HJ, Lee J, Lee H, Smith L, Rahmati M, Kang J, Papadopoulos NG, Cho SH, Hahn JW, Yon DK. Global Incidence and Prevalence of Chronic Rhinosinusitis: A Systematic Review. Clin Exp Allergy. 2025 Jan;55(1):52-66.
  • 6. DS Grewal, Ashish Chaturvedi. A study on the involvement of sinuses on CT among chronic rhinosinusitis patients. International Journal of Contemporary Medical Research 2019;6(10):J1-J3.
  • 7. Panda N, Verma RK, Panda NK. Efficacy and safety of high-concentration adrenaline wicks during functional endoscopic sinus surgery. J Otolaryngol Head Neck Surg. 2012 Apr;41(2):131-7.
  • 8. Silva A, Mourão J, Vale N. A Review of the Lidocaine in the Perioperative Period. J Pers Med. 2023 Dec 11;13(12):1699.
  • 9. Gunaratne DA, Barham HP, Christensen JM, Bhatia DD, Stamm AC, Harvey RJ. Topical concentrated epinephrine (1:1000) does not cause acute cardiovascular changes during endoscopic sinus surgery. Int Forum Allergy Rhinol. 2016;6(2):135-139.
  • 10. Hansson L, Midgren B, Karlsson JA. Effects of inhaled lignocaine and adrenaline on capsaicin-induced cough in humans. Thorax. 1994 Nov;49(11):1166-8.
  • 11. Omura K, Hosokawa Y, Nomura K, et al. Effect of gauze placement soaked with adrenaline at suprabullar recess on hemostasis during endoscopic sinus surgery: A randomized controlled trial. Head Neck. 2020;42(9):2397-2404.
  • 12. Muthukumar M, Arya VK, Mathew PJ, Sharma RK. Comparison of haemodynamic responses following different concentrations of adrenaline with and without lignocaine for surgical field infiltration during cleft lip and cleft palate surgery in children. Anaesth Intensive Care. 2012;40(1):114-119.
  • 13. Meas S, O’Brien EK, Stokken JK, et al. Anesthetic recovery outcomes after 2 methods of nasal mucosal preparation for endoscopic sinus surgery. Am J Otolaryngol. 2024;45(6):104414.
There are 13 citations in total.

Details

Primary Language English
Subjects Otorhinolaryngology
Journal Section Research Article
Authors

Saai Ram Thejas

Submission Date December 8, 2025
Acceptance Date December 13, 2025
Publication Date December 23, 2025
DOI https://doi.org/10.65396/ejra.1838060
IZ https://izlik.org/JA67LH67HN
Published in Issue Year 2025 Volume: 8 Issue: 3

Cite

APA Thejas, S. R. (2025). Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis. European Journal of Rhinology and Allergy, 8(3), 122-125. https://doi.org/10.65396/ejra.1838060
AMA 1.Thejas SR. Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis. Eur J Rhinol Allergy. 2025;8(3):122-125. doi:10.65396/ejra.1838060
Chicago Thejas, Saai Ram. 2025. “Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis”. European Journal of Rhinology and Allergy 8 (3): 122-25. https://doi.org/10.65396/ejra.1838060.
EndNote Thejas SR (December 1, 2025) Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis. European Journal of Rhinology and Allergy 8 3 122–125.
IEEE [1]S. R. Thejas, “Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis”, Eur J Rhinol Allergy, vol. 8, no. 3, pp. 122–125, Dec. 2025, doi: 10.65396/ejra.1838060.
ISNAD Thejas, Saai Ram. “Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis”. European Journal of Rhinology and Allergy 8/3 (December 1, 2025): 122-125. https://doi.org/10.65396/ejra.1838060.
JAMA 1.Thejas SR. Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis. Eur J Rhinol Allergy. 2025;8:122–125.
MLA Thejas, Saai Ram. “Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis”. European Journal of Rhinology and Allergy, vol. 8, no. 3, Dec. 2025, pp. 122-5, doi:10.65396/ejra.1838060.
Vancouver 1.Saai Ram Thejas. Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis. Eur J Rhinol Allergy. 2025 Dec. 1;8(3):122-5. doi:10.65396/ejra.1838060

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