Coblation is a unique method of delivering radio frequency energy to the soft tissue for applications in otolaryngology. It induces reduction of the inferior turbinate by vaporizing and destroying the soft erectile tissue. The volume reduction and tissue fibrosis are immediate and sustainable. Bleeding from the vascular capillary beds of the sinonasal mucosa compromises the surgical field and increases operative time and risk of complications. In this study we try to assist hemostasis with a multifaceted approach, including use of topical vasoconstrictors "phenylephrine" and systemic antifibrinolytic agent "tranexamic acid".
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
80
phenylephrine-soaked pack using the whole 5 ml of the solution provided with.5% phenylephrine will be applied after induction of surgery and intubation, 15 minutes before surgery. 100 ml of normal saline will be given.
patients will receive intravenous Single dose of tranexamic acid 15 mg/kg in 100 mL normal saline over 10 minutes. Saline-soaked pack will be applied.
surgical field scale
the intraoperative surgical site bleeding using the surgical field scale as follows: 0 = No bleeding 1. = Minimal bleeding: Not a surgical nuisance and no suction required 2. = Mild bleeding: Occasional suction required, but does not affect dissection 3. = Moderate bleeding: Slightly compromises surgical field, frequent suction required 4. = Severe bleeding: Significantly compromises surgical field, frequent suction required, bleeding threat field just after removal of suction 5. = Massive bleeding: Prevent dissection.
Time frame: intraoperativel
Volume of Blood loss
Time frame: intraoperative
Duration of surgery
Time frame: the duration from induction of anesthesia till extubation
Avoidance of postoperative nasal packing
if the patient can be spared from postoperatiove nasal pack inserted for controllling bleeding
Time frame: immediately after the surgey
Intra-operative and Postoperative complications
Complications such as nausea, vomiting, hypotnsion, hypertension, hemorraghic or thrombotic manifestations for 24 hours
Time frame: intraoperative and 24 hours postoperative
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