Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Dec 1994
Comparative StudyVasoconstrictive effects of cocaine and lidocaine with epinephrine in the hamster cheek pouch model.
Otolaryngologists frequently use cocaine and lidocaine with epinephrine for their anesthetic and vasoconstrictive effects. However, no studies have visually compared the vasoconstrictive effects of cocaine to lidocaine with epinephrine. This study used the everted hamster cheek pouch model to assess the vasoconstrictive effects of cocaine and lidocaine with epinephrine by measuring the diameter changes of arterioles. ⋯ Topical NaCl and injected NaCl controls showed no significant arteriolar reduction. Vasoconstrictive differences between the preparations were statistically significant (p < 0.05). Five percent cocaine is a much weaker vasoconstrictor than locally injected 1% lidocaine with 1:100,000 units epinephrine.
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Otolaryngol Head Neck Surg · Dec 1994
Hemostatic assessment of patients before tonsillectomy: a prospective study.
The purpose of this prospective study in patients undergoing tonsillectomy was to determine whether perioperative bleeding could be predicted by use of a standardized questionnaire concerning bleeding risk combined with measurement of the activated partial thromboplastin time and prothrombin time. Of the 96 patients enrolled in the study, none had a history of a severe bleeding disorder, but 6 (6%) had histories suggestive of a mild bleeding disorder. Further evaluation showed possible von Willebrand's disease in one of these patients. ⋯ The data provide further evidence that routine measurement of the activated partial thromboplastin time and prothrombin time in asymptomatic patients is not useful for predicting postoperative bleeding. In addition, histories suggestive of a mild bleeding disorder are also not accurate predictors of postoperative bleeding. Excessive bleeding associated with tonsillectomy is usually not a result of an identifiable coagulation disorder.