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European Archives of Oto-Rhino-Laryngology

Published in:

01-01-2019 | Review Article

Greater palatine canal injections reduce operative bleeding during endoscopic sinus surgery: a systematic review and meta-analysis

Authors: Se Hwan Hwang, Sung Won Kim, Soo Whan Kim, Byung Guk Kim, Jin Hee Cho, Jun Myung Kang

Published in: European Archives of Oto-Rhino-Laryngology | Issue 1/2019

Abstract

Objectives

The use of greater palatine canal (GPC) injections of a local anesthetic and a vasoconstrictor to decrease surgical bleeding during endoscopic sinus surgery (ESS) is controversial. We investigated the role of a preoperative GPC injection to minimize intraoperative bleeding during ESS in patients with chronic sinusitis through a meta-analysis of the relevant literature.

Data sources

PubMed, SCOPUS, and the Cochrane database.

Review methods

We screened the relevant literature published before May of 2018. Five articles that compared the pre-operative GPC injection (treatment group) with a placebo or no treatment (control group) were included for this analysis of the outcomes, which included an endoscopic grade of nasal bleeding and intraoperative hemodynamic stability during ESS.

Results

The endoscopic grade in the treatment group was significantly reduced when compared with the control group. No significant adverse effects were reported in the enrolled studies. The subgroup analyses of these results compared the concentrations of adrenalin (1:80,000 or 1:100,000), and adrenalin 1:80,000 showed significant effects on intraoperative bleeding when compared to adrenalin 1:100,000.

Conclusion

This study demonstrated that GPC injections of local anesthesia with 1:80,000 adrenaline for ESS effectively reduced intraoperative bleeding. Additionally, this procedure showed no significant adverse effects, such as hemodynamic instability. However, the standardized dosing needs further investigation and more trials.

Level of evidence

Ia.

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Title: Greater palatine canal injections reduce operative bleeding during endoscopic sinus surgery: a systematic review and meta-analysis
Authors: Se Hwan Hwang
Sung Won Kim
Soo Whan Kim
Byung Guk Kim
Jin Hee Cho
Jun Myung Kang
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 1/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5138-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Greater palatine canal injections reduce operative bleeding during endoscopic sinus surgery: a systematic review and meta-analysis

Abstract

Objectives

Data sources

Review methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Data sources

Review methods

Results

Conclusion

Level of evidence

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