Hernández PSH, Ortiz RA, García GCM

Language: Spanish
References: 37
Page: 3-7
PDF size: 145.21 Kb.

ABSTRACT

Objective: To compare the hemostatic effects of two substances derived from bismuth (subsalicylate and subgalate) with epinephrine in the surgery of the tonsils and adenoids.
Material and methods: We designed a prospective, longitudinal, controlled, randomized single-blind study of 45 male and female patients from 3 to 55 years old with surgical indication for tonsillectomy, adenoidectomy or adenotonsillectomy seen in Centro de Cirugia Ambulatoria, ISSSTE from August to December, 2009. Patients were divided randomly into 3 groups of 15 patients each one: group 1, which used a mixture of bismuth subsalicylate + epinephrine as topical hemostatic; group 2, which used a mixture of bismuth subgallate and epinephrine as topical hemostatic and group 3, which used sutures or electrocautery as hemostatic methods, all patient underwent outpatient surgery.
Results: We included 45 patients from 3 to 55 years old (average 9.8 years), of which 22 were women (48.8%) and 23 men (51.1%). Two patients (4.4%) underwent adenoidectomy; a patient (2.2%) underwent tonsillectomy and the 42 remaining underwent adenotonsillectomy. Average bleeding group was: group 1 (BSS) 85.40 mL; group 2 (BSG) 67.66 mL and control group 112.00 mL.
Conclusions: Significant difference among three study groups was observed (p = 0.045), which was identified among the group 2 (BSG) and control (p = 0.023). There was not statistically significant difference between group 1 (BSS) and group 2 (BSG) (p = 0.074). Bismuth subsalicylate and bismuth subgallate plus epinephrine showed similar hemostatic efficacy and safety in adenotonsillectomy performed.

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24. role in tonsillectomy. J Laryngol Otol 1995;109(3):203-205.

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26. aplicación de subgalato y subsalicilato de bismuto como

27. agentes hemostáticos después de la extracción quirúrgica

28. de terceros molares. Revista ADM 2003;LX(3):90-94.

29. Johnson BL, Elluru RG, Myer CM. Complications of adenotonsillectomy. Laryngoscope 2002;112:35-36.

30. Windfuhr JP, Chen YS, Remmert S. Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 2005;132(2):281-286.

31. Hernández PS, García GC. Consideraciones sobre amigdalectomía y adenoidectomía. An Orl Mex 2006;51(4):183- 191.

32. Thorisdottir H, Ratnoff OD, Maniglia AJ. Activation of Hageman factor (factor XII) by bismuth subgallate, a hemostatic agent. J Lab Clin Med 1988;112:481-486.

33. Montes de Oca RD, Ramírez MG, Hernández ML. Subsalicilato de bismuto como agente hemostático en la adenoamigdalectomía de estancia breve. An Orl Mex 1991;35(2):123-125.

34. Maniglia AJ, Kushener H, Cozzi L. Adenotonsillectomy: a safe outpatient procedure. Arch Otolaryngol Head Neck Surg 1989;115:92-94.

35. Callanan V, Curran AJ, Smyth DA, et al. The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy. J Laryngol Otol 1995;109(3):206-208.

36. Fenton JE, Blayney AW, O’Dwyer TP. Bismuth subgallate-its role in tonsillectomy. J Laryngol Otol 1995;109(3):203-205.

37. Mora LT, Trujillo FJ, Mora SJ. Eficacia y seguridad de la aplicación de subgalato y subsalicilato de bismuto como agentes hemostáticos después de la extracción quirúrgica de terceros molares. Revista ADM 2003;LX(3):90-94.