An observational study comparing the effect of sphenopalatine artery block on bleeding in endoscopic sinus surgery
Keywords:FESS, Sphenopalatine, Palatine, Lignocaine, Adrenaline, Bleeding
Background: The use of the sphenopalatine artery block to reduce bleeding during FESS, has been a debatable issue. This cross sectional observational study aims to study whether sphenopalatine artery block has any significant effect on bleeding.
Methods: 55 patients coming to the ENT department of Stanley Medical College from 2015–2016 were included in this study. All patients had bilateral nasal sinus disease and endoscopic sinus surgery was performed on both sides. 20 minutes prior to surgery one side was chosen randomly and sphenopalatine artery block was administered via the greater palatine canal approach. A mixture of lignocaine (2%) and adrenaline (1:80000) was used for infiltration. The surgery was done in an alternating fashion where the surgeon would operate for 15 minutes on one side and then moved onto the other side. The field was graded using the Wormald Grading at 30 minute intervals. The results were tabulated and the Wilcoxon Signed Rank Test was done at each time interval to see if there was a statistically significant difference in the grades of bleeding on both sides at each time interval. SPSS version 22.0 was used to analyse the data. Significance level was fixed as 5% (α=0.05).
Results: It was found that for each time interval up to 120 minutes there was a significant decrease in the bleeding on the blocked side. However after 120 minutes the bleeding on both sides appeared to be same.
Conclusions: Sphenopalatine artery block given prior to surgery will be effective in reducing bleeding in FESS for the first 2 hours after which the effect of the block wears away.
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