| ORIGINAL ARTICLE |
|
| Year : 2014 | Volume
: 30
| Issue : 4 | Page : 520-525 |
|
|
Effect of intramucosal infiltration of different concentrations of adrenaline on hemodynamics during transsphenoidal surgery
Nidhi Bhatia1, Babita Ghai1, Kishore Mangal1, Jyotsna Wig1, Kanchan K Mukherjee2
1 Departments of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India
2 Department of Neurosurgery, PGIMER, Chandigarh, India
Correspondence Address:
Nidhi Bhatia
Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9185.142848
|
|
|
Background and Aims: Neurosurgeons routinely instill vasopressors, with or without local anesthetics, to prepare nasal passages prior to transsphenoidal surgeries. As there is a paucity of data comparing the effect of intramucosal nasal infiltration of different concentrations of adrenaline that is, 1:200,000 and 1:400,000 in patients undergoing transsphenoidal surgery, we conducted this study to evaluate the effect of these two concentrations of adrenaline with 2% lignocaine on hemodynamics as well as bleeding.
Materials and Methods: Fifty-two American Society of Anesthesiologists I/II patients, aged 15-70 years, undergoing transsphenoidal surgery for pituitary or sellar masses were enrolled. Prior to surgical incision, nasal septal mucosa was infiltrated with lignocaine-adrenaline solution, after randomly allocating them to one of the two groups, with patients in Group A receiving intramucosal infiltration using 2% lignocaine with 1:200,000 adrenaline and those in Group B receiving 2% lignocaine with 1:400,000 adrenaline. Following infiltration, hemodynamic parameters were recorded every 1 min for 5 min and thereafter at every 5 min interval.
Results: Fewer patients (3/24 [12.5%]) in Group B had a rise of >50% in systolic blood pressure, from baseline values, after nasal mucosa infiltration as compared with patients in Group A (9/24 [37.5%]). In addition, mean rise in systolic, diastolic and mean arterial pressure was also significantly lower in Group B as compared with Group A.
Conclusion: Adrenaline in a concentration of 1:400,000 added to 2% lignocaine for nasal mucosa infiltration produces less hemodynamic response as compared with adrenaline 1:200,000 added to 2% lignocaine while at the same time providing similar operating conditions. |
|
|
|
| [FULL TEXT] [PDF]* |
|
 |
|
