Rasgon B M, Cruz R M, Hilsinger R L, Korol H W, Callan E, Wolgat R A, Selby J V
Department of Otolaryngology, Kaiser Permanente Medical Center, Oakland, CA 94611-5693.
Laryngoscope. 1991 Feb;101(2):114-8. doi: 10.1288/00005537-199102000-00002.
A variety of hemostatic agents and techniques have been used in an attempt to reduce intraoperative blood loss and postoperative bleeding in tonsillectomy. The efficacy of most of these substances and techniques has been judged primarily on clinical impressions. Because of the paucity of prospective studies, a randomized, prospective, double-blind study, using the patients as their own controls, was conducted. Ninety-two patients were injected before tonsillectomy in a random, double-blind fashion with normal saline solution in one tonsil and 1:100,000 epinephrine in the other. The blood loss, time of dissection, and postoperative bleeding were recorded separately for each tonsil. Cardiac manifestations were also monitored. The tonsils injected with epinephrine had a statistically significant reduction in blood loss and dissection time when compared with those injected with normal saline. Subjectively, dissection was easier on the epinephrine-injected side. There was no difference in the incidence of postoperative hemorrhage. Cardiac manifestations of epinephrine were minimal and transient. This study demonstrates that epinephrine is useful in reducing hemorrhage during tonsillectomy and can be used safely with the appropriate inhalation anesthetics.
为减少扁桃体切除术中的失血和术后出血，人们尝试了多种止血剂和技术。这些物质和技术的疗效主要是根据临床印象来判断的。由于前瞻性研究较少，因此进行了一项以患者自身为对照的随机、前瞻性、双盲研究。92例患者在扁桃体切除术前，以随机、双盲的方式，一侧扁桃体注射生理盐水，另一侧注射1:100,000肾上腺素。分别记录每个扁桃体的失血量、切除时间和术后出血情况。同时监测心脏表现。与注射生理盐水的扁桃体相比，注射肾上腺素的扁桃体在失血量和切除时间上有统计学意义的减少。主观上，注射肾上腺素一侧的切除更容易。术后出血的发生率没有差异。肾上腺素的心脏表现轻微且短暂。这项研究表明，肾上腺素在减少扁桃体切除术中的出血方面是有用的，并且在使用适当的吸入麻醉剂时可以安全使用。
