Comparison of different concentrations of adrenaline nasal packs in endoscopic sinus surgery: A prospective randomized double-blind study

Background : Endoscopic sinus surgery has become a prevalent procedure in rhinology, aimed at treating various sinonasal conditions. A critical factor affecting surgical outcomes is the haemostasis achieved during the operation, as adequate control of bleeding can significantly influence both visibility and overall success. Aims and Objectives: This study aims to compare the effects of two concentrations of adrenaline (epinephrine) 1:1000 and 1:2000 on intraoperative visibility and systemic physiological parameters. The objective was to assess whether different concentrations provide distinct advantages in terms of local vasoconstriction and potential systemic effects. Materials & Methods : Adrenaline was administered via soaked pledgets to achieve local vasoconstriction. Local Effects: Visibility of the surgical field, which was quantified based on bleeding control and Systemic effects: Heart rate, systolic and diastolic blood pressure, mean arterial pressure, and evidence of systemic absorption of adrenaline were measured. Data were collected and analysed to compare the outcomes between the two groups receiving different concentrations. Conclusion: Our findings indicate that both concentrations of adrenaline (1:1000 and 1:2000) were equally effective in achieving a bloodless surgical field, facilitating optimal visibility during the procedure. Furthermore, there were no significant alterations in the haemodynamic parameters for either concentration, suggesting a similar safety profile. No systemic complications were observed, confirming that both concentrations are safe for use in endoscopic sinus surgery. Thus, clinicians may choose either concentration depending on their preference, without concern for differing outcomes in efficacy or safety.