MedPath

Effects of Adrenaline Infiltration on Surgical Field of View in Endoscopic Sinus Surgery

Phase 4
Completed
Conditions
Intraoperative Bleeding
Interventions
Drug: Saline
Registration Number
NCT05867342
Lead Sponsor
Stanford University
Brief Summary

In endoscopic sinus surgery a clear surgical field of view is a very important aspect for good surgical outcome. This study is to evaluate the preoperative preparation to acquire best surgical field of view by comparing between the use of topical adrenaline and the use of combination of topical adrenaline with infiltration of 1% lidocaine with adrenaline in patients scheduled for endoscopic sinus surgery for rhinosinusitis.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Diagnosed with recurrent acute or chronic rhinosinusitis recalcitrant to medical treatment and scheduled for endoscopic sinus surgery
Exclusion Criteria
  • Patients who have asymetrical disease on the two sides (Lund Mackay score difference more than 2)
  • Patients who have endoscopic sinus surgery for treatment of tumor or disease other than sinusitis
  • Patients with underlying uncontrolled hypertension
  • Patients with bleeding disorder or are unable to discontinue antiplatelet or anticoagulant before the surgery
  • Patients who are allergic to adrenaline or to xylocaine

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Endoscopic sinus surgerySalineParticipants receive topical 1:1000 epinephrine plus saline in one nostril, and topical 1:1000 epinephrine plus infiltration of 1% lidocaine with 1:100,000 epinephrine in the other nostril, during endoscopic visualization while undergoing Endoscopic sinus surgery (ESS).
Endoscopic sinus surgeryEpinephrinParticipants receive topical 1:1000 epinephrine plus saline in one nostril, and topical 1:1000 epinephrine plus infiltration of 1% lidocaine with 1:100,000 epinephrine in the other nostril, during endoscopic visualization while undergoing Endoscopic sinus surgery (ESS).
Primary Outcome Measures
NameTimeMethod
Surgical Field Grading Scorepostoperatively (approximately 20 minutes to assess)

The video recording of the endoscopic sinus surgery of the participant was graded by another otolaryngology specialist postoperatively and graded according to Wormald Surgical Field Grading Scale. Scores range from 0 (no bleeding) to 10 (severe bleeding with nasal cavity filling rapidly).

Secondary Outcome Measures
NameTimeMethod
Duration of Surgeryintraoperatively (up to 3 hours)
Postoperative Bloody Discharge Grading Score1 week after the surgery (up to 2 minutes to complete assessment)

Grading of postoperative bloody discharge postoperatively assessed by patient using the 1-week postoperative bleeding questionnaire. Scores range from 0 (no bleeding) to 5 (continuous heavy bleeding necessitating medical care).

Estimated Blood Loss During Surgeryintraoperatively (up to 3 hours)
Number of Extra Pledgets Usedintraoperatively (up to 3 hours)

A pledget is a small wad of absorbent material used to stop bleeding.

Number of Days With Postoperative Bloody Nasal Discharge1 week after the surgery (up to 2 minutes to complete assessment)

Participants indicated number of days with bloody nasal discharge postoperatively using the 1-week postoperative bleeding questionnaire.

Number of Nostrils With Continuous Fresh Bleeding1 week after the surgery (up to 2 minutes to complete assessment)

Number of nostrils with excessive fresh bleeding postoperatively using the 1-week postoperative bleeding questionnaire. Continuous fresh bleeding was defined as bleeding for over 15 minutes.

Trial Locations

Locations (1)

Stanford

🇺🇸

Stanford, California, United States

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