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WSU Medical School

Training Level

Medical Student


Wayne State University


Topical epinephrine is proven to be safe and effective during endoscopic endonasal surgery when used appropriately. Our aim is to evaluate the hemodynamic effects of topical 1:1000 epinephrine under general anesthesia both preoperatively and intraoperatively using wrung out pledgets. 22 patients undergoing endoscopic endonasal surgery with various pathologies were evaluated for the study. Heart rate, blood pressure, and ECG measures were recorded for 7 minutes after epinephrine pledget placement both preoperatively and intraoperatively. Preoperatively, beside a transient increase and decrease in diastolic blood pressure, there were no significant changes in hemodynamics. Intraoperatively, there were no significant elevations in heart rate, blood pressure, and no ECG abnormalities recorded for all 22 patients even after placement of 8 epinephrine wrung out pledgets placed in various locations throughout the nasal cavity. However, the systolic, diastolic, and mean arterial pressure decreased within 2 minutes after the placement the epinephrine pledgets and remained decreased for the total 7 minutes (p<0.05). Significant heart rate and ECG changes were not observed. Sensible use of topical 1:1000 epinephrine using wrung out pledgets in various pathologies should not cause changes in systemic hemodynamic parameters that would require intervention under general anesthesia.

Presentation Date


Hemodynamic changes with placement of wrung-out topical 1: 1000 epinephrine nasal pledgets before and during endoscopic sinonasal surgery