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The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy

Published online by Cambridge University Press:  29 June 2007

Vincent Callanan*
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
Aongus J. Curran
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
David A. Smyth
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
Peter K. Gormley
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
*
Address for correspondence: Mr Vincent Callanan, F.R.C.S., F.R.C.S.I., Registrar, Department of ENT Surgery, 2nd Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7TH.

Abstract

The aims of this study were to demonstrate the effect of bismuth subgallate and adrenaline paste application to the tonsillar fossae on operating time and peroperative blood loss during tonsillectomy. Ninety-eight patients were included in a prospective randomized trial.

Bismuth subgallate powder is mixed with 10 ml of normal saline and 0.03 ml of 1:1000 adrenaline to make a paste. This paste is used as a topical haemostatic agent during tonsillectomy. Bismuth subgallate activates Factor XII and therefore accelerates the coagulation cascade. Adrenaline causes vasoconstriction and promotes platelet aggregation. The application of bismuth subgallate and adrenaline paste to the tonsillar fossae during tonsillectomy reduces operating time by 23 per cent for Consultant staff (p<0.05) and 32 per cent for Junior staff (p<0.05). Blood loss is reduced by 21 per cent (p>0.05), for the average paediatric tonsillectomy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

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