Systemic Absorption of Adrenalin after Injection Administration into Nasal Mucosa
Authors:
P. Matoušek 1; P. Komínek 1; J. Chalupa 2; A. Garčic 3
Authors‘ workplace:
ORL klinika FN Ostrava
; přednosta MUDr. P. Komínek, Ph. D.
ARO oddělení Nemocnice ve Frýdku-Místku
1; primář MUDr. J. Chalupa
Biochemická laboratoř, Poliklinika Místek
2; primář RNDr. A. Garčic
3
Published in:
Otorinolaryngol Foniatr, 56, 2007, No. 3, pp. 137-143.
Category:
Original Article
Overview
Objective:
The study investigated the levels of systemically absorbed adrenalin after injection administration in endonasal operations.
Type of study:
prospective study
Setting:
ORL Clinin, Faclty Hospital Ostrava, ORL Ward of the Hospital at Frydek-Mistek
Material and Methods:
A prospective follow-up was evaluated in a group of patients having been administered adrenalin by injection into nasal mucosa in general anesthesia. After introduction of general anesthesia venous blood was sampled for the determination of “basal” level of adrenalin. Subsequently, 6 ml of adrenalin in the 1:100 000 dilution was administered by injection into nasal mucosa. Venous blood was sampled in min 1, 3, 5 and 10 after the administration for the determination of adrenalin levels by ELISA. These levels were compared with the adrenalin level before the administration. Clinical response to the administered adrenalin (BP, HR) was detected. The depth of general anesthesia was monitored by bispectral index.
Results:
22 patients (15 men, 7 women) at the average age of 22 years were examined (the oldest being 64 years and the youngest 18 years old). The infection administration of adrenalin resulted in significantly increased adrenalin levels in 1,, 3rd,5th and 10th minute (maximum 865 ng/l in the 1st minute) with a subsequent decline to almost basal values in the 10th minute. There was a significant increase in systolic pressure in the 1st minute as compared with the basal BP. The diastolic blood pressure was significantly less in min 5 and 120 after the administration and there was a significant decrease of heart rate 10 min after the administration.
Conclusion:
after the injection administration of adrenalin into nasal mucosa in the 1:100 000 dilution there was an increased in adrenalin levels in venous blood up to 10-fold basal levels. Inspite of the fact that there were significant changes in blood pressure and heart rate, the changes were minimal and did not fall outside standard course of anesthesia. A sufficiently deep anesthesia minimizes reactivity of the organism to exogenously administered adrenalin and in minimizing the endogenous adrenalin production decreases the risk of possible complications.
Key words:
adrenalin, injection administration, systemic absorption.
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
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