Effect Of Pterygopalatine Fossa Lidocaine: Adrenaline Injection on Surgical Field During Endoscopic Nasal Surgery

Bleeding into the surgical field is a major issue faced by endoscopic surgeons particularly if it is performed in narrow confines of the nasal cavity. Objective: To determine whether infiltration of a mixture of lidocaine: adrenaline into pterygopalatine fossa has an effect on intraoperative field bleeding during endoscopic nasal surgery. Methods: A prospective, double blinded study was undertaken to assess 88 patients who had endoscopic nasal surgery indicated for chronic sinusitis with or without nasal polyps and dacryocystorhinostomy. Patients who received injection were selected randomly and the same anaesthetist infiltrated a solution of 2% lidocaine and 1:100,000 adrenaline into pterygopalatine fossa of all patients. All operations were undertaken by the same surgeon who assessed intraoperative bleeding every 15 minutes according to Boezaart and Van der Merwe grading system. Results: The difference in the degrees of bleeding among patients who received versus those who did not receive injection was not statistically significant (p-value = 0.36). Conclusion: According to the dose of treatment and condition applied in these operations, it seems that pterygopalatine fossa injection with lidocaine: adrenaline does not decrease intraoperative bleeding during endoscopic nasal surgery.