Nasal Desmopressin Versus Topical Epinephrine in Endonasal Dacryocystorhinostomy

Zagazig University

Status: Completed

Conditions: Anesthesia

Treatments: Drug: Desmopressin Acetate Nasal, 10 μg/0.1 ml per spray; Drug: Epinephrine topical 1:100,000 Nasal Packs

Study type: Interventional

Funder types: Other

Identifiers

NCT05507476

Nasal Desmopressin in DCR

Details and patient eligibility

About

Dacryocystorhinostomy aims to create a channel between the lacrimal sac and nasal mucosa to relieve nasolacrimal duct occlusion. General anesthesia is still preferred by many surgeons to secure the airway and control blood pressure.

Full description

Bleeding even minor can obscure the surgical field. This can extend the operative time & increase the failure rate. The hemostatic effect of desmopressin on the quality of the surgical field was investigated in patients undergoing endoscopic sinus surgery and revealed that desmopressin could reduce intraoperative bleeding.

Enrollment: 52 patients

Sex: All

Ages: 18 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: 18-45 years old.
• Physical status: ASA I & II.
• Type of operations: elective endonasal dacryocystorhinostomy under general anesthesia.
• Written informed consent from the patient.

Exclusion criteria

• Patient refusal.
• Known hypersensitivity to study drugs.
• Nasal pathology as active infection or an anatomical abnormality.
• Hyponatremia "serum Na+ less than 135".
• Coagulation disorders.
• Renal or cardiovascular disorders.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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52 participants in 2 patient groups

Desmopressin group

Active Comparator group

Description:

The patient will receive two puffs of desmopressin acetate 10 µg/puff in the side of the nasal cavity ipsilateral to the obstructed lacrimal duct (20 μg totally) 60 minutes before surgery "Minirin 10 μg/0.1 ml per spray, Ferring Pharmaceutical Company". Three normal saline-soaked packs will be placed in the middle meatus for 5 minutes immediately before the start of surgery.

Treatment:

Drug: Desmopressin Acetate Nasal, 10 μg/0.1 ml per spray

Epinephrine group

Active Comparator group

Description:

The patient will receive topical 1:100,000 epinephrine in the side of the nasal cavity ipsilateral to the obstructed lacrimal duct via 3 soaked packs placed in the middle meatus for 5 minutes immediately before the start of surgery. The patient will also receive two puffs of normal saline "prepared in emptied Minirin bottle" in the same nasal cavity 60 minutes before surgery.

Treatment:

Drug: Epinephrine topical 1:100,000 Nasal Packs