bismuth-subgallate and Blood-Loss--Surgical

The aims of this study were to demonstrate the effect of bismuth subgallate and adrenaline paste application to the tonsillar fossae on operating time and peroperative blood loss during tonsillectomy. Ninety-eight patients were included in a prospective randomized trial. Bismuth subgallate powder is mixed with 10 ml of normal saline and 0.03 ml of 1:1000 adrenaline to make a paste. This paste is used as a topical haemostatic agent during tonsillectomy. Bismuth subgallate activates Factor XII and therefore accelerates the coagulation cascade. Adrenaline causes vasoconstriction and promotes platelet aggregation. The application of bismuth subgallate and adrenaline paste to the tonsillar fossae during tonsillectomy reduces operating time by 23 per cent for Consultant staff (p < 0.05) and 32 per cent for Junior staff (p < 0.05). Blood loss is reduced by 21 per cent (p > 0.05), for the average paediatric tonsillectomy.

Topics: Adolescent; Blood Loss, Surgical; Drug Combinations; Epinephrine; Gallic Acid; Hemostatics; Humans; Medical Staff, Hospital; Organometallic Compounds; Prospective Studies; Time Factors; Tonsillectomy

Tonsillectomy, with or without adenoidectomy, is one of the most commonly performed surgical procedures and as such contributes significantly to the surgery performed by GPs and ENT surgeons. In this randomized controlled study we compared the use of a compound bismuth subgallate (BSG) during adeno-tonsillectomy with the standard operations. Two hundred and two tonsillectomies were randomized into two groups. BSG was used in 90 patients while the other 112 patients were used as controls. The mean operating time was reduced from 11.5 to 9.9 minutes, the number of swabs from 4.5 to 3.7 and number of ties from 3.4 to 2.1. All these reductions were significant (p-values all < 0.05). There were no post-operative complications in either group. Thus the use of BSG during adeno-tonsillectomy or tonsillectomy alone significantly decreases the operating time and results in less intraoperative haemorrhage with fewer ties and swabs being required.

Topics: Adenoidectomy; Adolescent; Blood Loss, Surgical; Child; Female; Gallic Acid; Hemostasis, Surgical; Hemostatics; Humans; Intraoperative Period; Male; Organometallic Compounds; Tonsillectomy