Uso tópico da adrenalina em diferentes concentra？？es na cirurgia endoscópica nasal

the ideal adrenaline concentration remains unknown. aim: compare topical adrenaline solutions in different concentrations. study design: prospective, double blind, randomized trial. patients and methods: 49 patients divided in 3 groups underwent endoscopic sinus surgery, using only topical solutions of adrenaline in different concentrations (1:2,000, 1:10,000 and 1:50,000). we compared the duration of surgery, intra-operative bleeding, plasmatic levels of catecholamines, hemodynamic parameters and changes in heart rhythm. results: surgery time was shorter in the group using adrenaline 1:2,000, which also showed less bleeding in all evaluations (objective and subjective - p < 0.0001). plasmatic levels of epinephrine rose in all groups, more sharply in the 1:2,000 group. there was a trend towards elevation of blood pressure in the groups using adrenaline 1:2,000 and 1:10,000, with a greater occurrence of hypertensive peaks. discussion: we found a very significance bleeding difference favoring the 1:2,000. the blood pressure elevation in the 1:2,000 and 1:10,000 groups was progressive but very slow throughout the procedure, which could be associated with the anesthesia technique. conclusion: we favor the use of topical adrenalin 1:2,000 due to a clear superiority in hemostasis. further investigation is needed to corroborate our findings.