[Evaluation of topical vasoconstrictors in pterygium surgery and their role in reducing intraoperative bleeding].

Abstract

OBJECTIVE:

To reduce vascularisation before surgery through the application of topical vasoconstrictors, decreases the rate of intraoperative bleeding, improves the dynamics of the surgery and reduces the difficulty in surgical performance.

METHODS:

Only patients with primary pterygium were included in the study. A prospective randomized clinical trial was designed to compare intraoperative bleeding, need for cauterization and surgical time a group that was administered phenylephrine. preoperatively and one which did not receive it. The sample was divided into two groups: 1st (n=27) received topical phenylephrine (F) 0.1 ml (10%), twice in 5 minutes before surgery. 2nd (n=30) did not receive phenylephrine (NoF). The technique was similar in both groups using conjunctival autograft suturing. In both groups, the subconjunctival aneasthesia was performed with 0.5% bupivacaine hydrochloride with epinephrine 1:200,000.

RESULTS:

A total of 57 patients were included in the study. The mean operation time for group F was 15.57 minutes (SD: 1.8 min) and the NoF group 16.51 min (SD to 1.82 min, P=.057). In the group F, it was necessary to use diathermy in 2 patients (7.4%) and in the NoF group cauterisation was used in 14 patients (46.7%, Chi-Square=10.848, P=.001. There is a relative risk 6.3 (95% CI 1.57 - 25.27) times greater than having to cauterise without phenylephrine when used phenylephrine.

CONCLUSIONS:

The use of topical vasconstrictors prior to pterygium surgery reduces the rate of bleeding and the time of surgery.

• Authors: E Villegas Becerril, L Pérula de Torres, M Bergillos Arillo, C Villegas del Cuvillo
• Journal: Archivos de la Sociedad Espanola de Oftalmologia (Arch Soc Esp Oftalmol) Vol. 86 Issue 2 Pg. 54-7 (Feb 2011) ISSN: 1989-7286 [Electronic] Spain
• Vernacular Title: Evaluación de vasoconstrictores tópicos en la cirugía del pterigión y su papel en la disminución del sangrado intraoperatorio.
• PMID: 21440831 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Chemical References

• Adjuvants, Anesthesia
• Anesthetics, Local
• Vasoconstrictor Agents
• Phenylephrine
• Bupivacaine
• Epinephrine

Topics

• Adjuvants, Anesthesia
• Administration, Topical
• Anesthetics, Local
• Blood Loss, Surgical (prevention & control)
• Bupivacaine
• Conjunctiva (transplantation)
• Electrocoagulation (statistics & numerical data)
• Epinephrine
• Female
• Humans
• Male
• Middle Aged
• Phenylephrine (administration & dosage, therapeutic use)
• Preanesthetic Medication
• Prospective Studies
• Pterygium (surgery)
• Risk
• Suture Techniques
• Time Factors
• Transplantation, Autologous
• Vasoconstrictor Agents (administration & dosage, therapeutic use)