Pub Date : 2021-01-01DOI: 10.12970/2308-7978.2021.09.03
R. Ramos, O. Filho, L. Faidiga, M. Faleiros, Enzo Souza, J. Amaral, Júlia Ribeiro Bortolato, Mayara de Almeida Hentz Della Corte, Olivia Mendes Amêndola, Catarine Vieira Machado, Dimoriani Cristina Pinheiro
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Pub Date : 2019-05-11DOI: 10.12970/2308-7978.2019.07.02
S. Heuvel, B. Borne, J. Engel, M. Snoeck
Objective : Endonasal cocaine gauzes are applied during functional endoscopic sinus surgery (FESS) for their combined analgesic and decongestive properties. Seeking an alternative for cocaine, tetracaine/oxymetazoline, and ropivacaine/oxymetazoline were investigated for their efficacy and safety during FESS. Methods : Over 18 months a double-blinded randomised prospective intervention study was conducted. Ninety patients were allocated to 3 groups that received a blinded 5 ml solution containing cocaine 5 %, tetracaine 0.8 % plus oxymetazoline 0.02 % or ropivacaine 0.8% plus oxymetazoline 0.02 %. Two Ear Nose Throat surgeons participated and evaluated preprocedural decongestion, postoperative decongestion and haemostasis according to a numeric rating scale (NRS, 0 - 10). Postoperative pain scores (NRS) registered until discharge. Secondary outcomes were intraoperative blood loss, perioperative hemodynamics, postoperative bandage changes, morphine consumption, nausea and vomiting. Results : No significant difference was observed between groups for preprocedural decongestion (p = 0.72) and postoperative decongestion (p = 0.48) and haemostasis (p = 0.44). Mean postoperative pain scores were low (NRS 1.00, SD 1.15) without significant difference (p = 0.55). Conclusion : Based on the results of this study we can recommend tetracaine / oxymetazoline or ropivacaine / oxymetazoline as a safe and effective topical agent for FESS that can replace cocaine.
{"title":"Cocaine, Tetracaine / Oxymetazoline and Ropivacaine / Oxymetazoline in Functional Endoscopic Sinus Surgery","authors":"S. Heuvel, B. Borne, J. Engel, M. Snoeck","doi":"10.12970/2308-7978.2019.07.02","DOIUrl":"https://doi.org/10.12970/2308-7978.2019.07.02","url":null,"abstract":"Objective : Endonasal cocaine gauzes are applied during functional endoscopic sinus surgery (FESS) for their combined analgesic and decongestive properties. Seeking an alternative for cocaine, tetracaine/oxymetazoline, and ropivacaine/oxymetazoline were investigated for their efficacy and safety during FESS. Methods : Over 18 months a double-blinded randomised prospective intervention study was conducted. Ninety patients were allocated to 3 groups that received a blinded 5 ml solution containing cocaine 5 %, tetracaine 0.8 % plus oxymetazoline 0.02 % or ropivacaine 0.8% plus oxymetazoline 0.02 %. Two Ear Nose Throat surgeons participated and evaluated preprocedural decongestion, postoperative decongestion and haemostasis according to a numeric rating scale (NRS, 0 - 10). Postoperative pain scores (NRS) registered until discharge. Secondary outcomes were intraoperative blood loss, perioperative hemodynamics, postoperative bandage changes, morphine consumption, nausea and vomiting. Results : No significant difference was observed between groups for preprocedural decongestion (p = 0.72) and postoperative decongestion (p = 0.48) and haemostasis (p = 0.44). Mean postoperative pain scores were low (NRS 1.00, SD 1.15) without significant difference (p = 0.55). Conclusion : Based on the results of this study we can recommend tetracaine / oxymetazoline or ropivacaine / oxymetazoline as a safe and effective topical agent for FESS that can replace cocaine.","PeriodicalId":17093,"journal":{"name":"Journal of Rhinolaryngo-Otologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73216467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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