Efficacy of Topical Epinephrine in Tympanoplasty. (22nd June 2021)

• Record Type: Journal Article
• Authors: List, Marna A.; Dirain, Carolyn O.; Haberman, Rex S.; Antonelli, Patrick J.
• Is Part Of: Laryngoscope. Volume 131:Number 10(2021)
• Page Start: 2319
• Page End: 2322
• Publication Date: 2021-06-22
• Subjects: Epinephrine -- tympanoplasty -- safety -- hemostasis -- efficacy; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.29688
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objectives/Hypothesis: To compare the hemostatic effects of commonly used concentrations of topical epinephrine in tympanoplasty. Study Design: Prospective, randomized, controlled clinical trial. Methods: Patients undergoing tympanoplasty were randomized to receive topical epinephrine at 1:1, 000 or 1:10, 000. With the investigators blinded, hemostasis was assessed with a modified Boezaart scale. Vasoconstriction was measured by laser Doppler. Blood pressure and pulse were tracked. Results: Thirty patients, 4 to 84 years old, were studied, with 15 patients per group. Boezaart scores dropped a mean of 67% and 62% with 1:1, 000 and 1:10, 000, respectively ( P = .44). Capillary blood flow decreased a mean of 50.4% and 50.9% with 1:1, 000 and 1:10, 000, respectively ( P = .95). The mean change in heart rate and mean arterial pressure after topical epinephrine exposure were −4.9 and −0.73 beats per minute ( P = .15), and −0.60 and −0.73 mmHg ( P = .96) for 1:1, 000 and 1:10, 000 respectively. No adverse events occurred in either group. Conclusions: Topical epinephrine at 1:10, 000 has hemostatic efficacy comparable to 1:1, 000 in tympanoplasty. Although both concentrations appear safe, use of topical epinephrine 1:10, 000 should be considered over 1:1, 000 to minimize the potential for adverse events. Level of Evidence: 2 Laryngoscope, 131:2319–2322, 2021