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Phenylephrine as an alternative to cocaine for nasal vasoconstriction before nasal surgery: A randomised trial
- Source :
- Indian Journal of Anaesthesia, Vol 57, Iss 2, Pp 163-169 (2013)
- Publication Year :
- 2013
- Publisher :
- Wolters Kluwer Medknow Publications, 2013.
-
Abstract
- Background: Cocaine is often used topically to provide the profound vasoconstriction required for nasal surgery; however, it has been associated with intraoperative cardiac adverse effects. We compared cocaine with phenylephrine as an alternative to ascertain their relative efficacy as vasoconstrictors in nasal septoplasty. Methods: Adult patients, presenting for elective nasal septoplasty, of American Society of Anaesthesiologists physical status I-III, were randomised to either 0.5% phenylephrine or 4% cocaine. The primary outcome was quality of vasoconstriction on a 5-point scale (1=unacceptable, 5=excellent), rated by the surgeon at the end of the procedure. Results: Twenty-nine patients received phenylephrine and 26 received cocaine. The median rating for quality of the vasoconstriction was 4.0 (good) in both the phenylephrine and cocaine groups ( P=0.84). Median blood loss was 50 ml in the phenylephrine group and 62.5 ml in the cocaine group ( P=0.49). In secondary analyses, phenylephrine was shown to be non-inferior to cocaine on both quality of vasoconstriction (non-inferiority delta of 1 point, P=0.009) and estimated blood loss (non-inferiority delta of 25 ml, P=0.028). The frequency of ventricular ectopy, ST segment changes or blood pressure changes after nasal packing was not significantly different between the two groups. Conclusion: Phenylephrine in a concentration of 0.5% is not different from 4% cocaine on the quality of vasoconstriction in septoplasty. Given the abuse potential of cocaine and the added administrative burden associated with its handling, phenylephrine might serve as an alternative.
Details
- Language :
- English
- ISSN :
- 00195049
- Volume :
- 57
- Issue :
- 2
- Database :
- Directory of Open Access Journals
- Journal :
- Indian Journal of Anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.611344236363453ea00481f1ba651912
- Document Type :
- article
- Full Text :
- https://doi.org/10.4103/0019-5049.111844