Efficacy of Topical Epinephrine in Tympanoplasty

xlomafota13 shared this article with you from Inoreader Efficacy of Topical Epinephrine in Tympanoplasty Via The Laryngoscope 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, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.