|Zuzanna Pujanek, Katarzyna Wawrzyniak, Paweł Krzysztof Burduk, Krzysztof Kusza|
Introduction. When conservative therapy procedures prove
to be ineffective, the treatment of choice for chronic sinusitis,
including cases with accompanying nasal polyps, is endoscopic
sinus surgery (ESS). ESS procedures are usually performed under
general anesthesia, but the simultaneous application of topical
anesthetic preparations/decongestants to insensibilize and decrease
nasal mucosa oedema may add to the overall success.
Aim. The aim of this study was to compare the available local
anesthetics used in ESS surgery, with particular reference to
indications and contraindications for their use.
Methods. This paper explores the relevant literature and reports
authors’ own experience in the intraoperative application
of local anesthetics and decongestants.
Results. Currently, the most commonly used preparations
are: lidocaine (typically 2%) supplemented with adrenaline at
a concentration of 1:200.000 or 1:100.000, oxymetazoline
0.05% or 0.1 % and the aqueous solutions of cocaine, typically
4% (although use of 20% solution has been also reported).
However, these drugs are not free of side effects that must be
considered when using them.
Conclusions. To ensure optimum ESS conditions, along with
improving endoscopic surgery techniques there is a need to
search for an agent that shows local anesthetic activity and
reduces bleeding from mucous membrane of the nasal cavity,
and at the same time does not produce undesirable side effects
or systemic complications.
keywords: znieczulenie miejscowe, leki, endoskopowa chirurgia nosa i zatok,local anesthesia, medications, endoscopic nasal and sinus surgery
pages: from 112 to 116
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