Nasal Desmopressin Versus Topical Epinephrine in Endonasal Dacryocystorhinostomy

Effects of Nasal Desmopressin Spray Versus Topical Epinephrine on Surgical Field Clarity and Hemodynamics in Endonasal Dacryocystorhinostomy: a Randomized Clinical Study.

Dacryocystorhinostomy aims to create a channel between the lacrimal sac and nasal mucosa to relieve nasolacrimal duct occlusion. General anesthesia is still preferred by many surgeons to secure the airway and control blood pressure.

Bleeding even minor can obscure the surgical field. This can extend the operative time & increase the failure rate. The hemostatic effect of desmopressin on the quality of the surgical field was investigated in patients undergoing endoscopic sinus surgery and revealed that desmopressin could reduce intraoperative bleeding.

Inclusion Criteria:

• Age: 18-45 years old.
• Physical status: ASA I & II.
• Type of operations: elective endonasal dacryocystorhinostomy under general anesthesia.
• Written informed consent from the patient.

Exclusion Criteria:

• Patient refusal.
• Known hypersensitivity to study drugs.
• Nasal pathology as active infection or an anatomical abnormality.
• Hyponatremia "serum Na+ less than 135".
• Coagulation disorders.
• Renal or cardiovascular disorders.