Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-23T07:23:28.212Z Has data issue: false hasContentIssue false

Local anaesthetic with vasoconstrictor combinations in septal surgery

Published online by Cambridge University Press:  29 June 2007

L. G. Mcclymont*
Affiliation:
Glasgow
J. A. Crowther
Affiliation:
Glasgow
*
Mr Leo G McClymont, Department of Otolaryngology, The Victoria Infirmary, Glasgow G42 9TY.

Abstract

Local anaesthetic with vasoconstrictor combinations are often used to reduce bleeding and hence improve the operating field in septal surgery. Two commonly used combinations are lignocaine with adrenaline and prilocaine with felypressin (citanest with octapressin). Most surgeons prefer to use lignocaine with adrenaline but because of the risks of cardiac dysrhythmias when used with halothane anaesthetists prefer prilocaine with felypressin. In a trial with lignocaine 2 per cent and adrenaline 1 in 200,000 against prilocaine 3 per cent and felypressin 0.03 international units/ml in 18 patients undergoing septal surgery with local anaesthesia alone there was significantly less blood loss in the lignocaine with adrenaline group, p>0.01. The mean blood loss in the adrenaline group was 7.5 ml. and 32.7 ml. with felypressin. Both combinations were equally effective in producing adequate local anaesthesia. It is concluded that lignocaine with adrenaline is superior to prilocaine with felypressin in achieving a dry operating field in septal surgery under local anaesthesia.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Johnston, M., and Nisbet, H. I. A. (1961) Ventricular arrhythmias during halothane anaesthesia. British Journal of Anaesthesia 33: 916.CrossRefGoogle Scholar
Katz, R. L., Matteo, R. S., and Papper, E. M. (1962) The injection of epinephrine during general anesthesia with halogenated hydrocarbons and cyclopropane in man. 2. Halothane. Anesthesiology 23: 597600.CrossRefGoogle ScholarPubMed
Klingenstrom, P., Nylen, B. and Westermark, L. (1967) A clinical comparison between adrenaline and octapressin as vasoconstric-tors in local anaesthesia. Acta Anaesthesia Scandinavia 11: 3542.CrossRefGoogle Scholar
Millar, R. A., Gilbert, R. G. B., Brindle, G. F. (1958) Ventricular tachycardias during halothane anaesthesia. Anaesthesia 13:164–72.CrossRefGoogle Scholar
Munchow, O. B. and Kurze, T. (1966) Hemostatic effectiveness of infiltration with felypressin prior to skin incisions. Journal of the American Medical Association, 196(7): 625626.CrossRefGoogle ScholarPubMed
Shanks, C. A. (1963) Intravenous octapressin during halothane anaesthesia. British Journal of Anaesthesia, 35: 640643CrossRefGoogle ScholarPubMed
Sumikawa, K., Ishizaka, N. and Suzaki, M. (1983) Arrhythmogenic plasma levels of epinephrine during halothane, enflurane and pentobarbital anaesthesia in the dog. Anesthesiology 58: 322–5.CrossRefGoogle ScholarPubMed
Thornton, J. A., Saynor, R., Schroeder, H. G., Taylor, D. G. and Verel, D. (1963) Estimation of blood loss with particular reference to cardiac surgery. British Journal of Anaesthesia, 35: 9199.CrossRefGoogle ScholarPubMed