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The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy

Published online by Cambridge University Press:  29 June 2007

Vincent Callanan ,
Aongus J. Curran ,
David A. Smyth  and
Peter K. Gormley
Vincent Callanan*
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
Aongus J. Curran
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
David A. Smyth
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
Peter K. Gormley
Affiliation:
Department of ENT Surgery, University College Hospital, Galway, Ireland
*
Address for correspondence: Mr Vincent Callanan, F.R.C.S., F.R.C.S.I., Registrar, Department of ENT Surgery, 2nd Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7TH.
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Abstract

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.

Keywords

Tonsillectomy, Haemostatic techniques
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 3 , March 1995 , pp. 206 - 208
Copyright
Copyright © JLO (1984) Limited 1995

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References

Finar, I. L. (1975) Gallic acid. In Organic Chemistry. 5th Edition. vol. 2. Longman, London, p 783.Google Scholar
Goh, C. L., Ng, S. K. (1987) Contact allergy to iodoform and bismuth subnitrate. Contact Dermatitis 16: 109–110.CrossRefGoogle ScholarPubMed
Maniglia, A. J., Kushner, H., Cozzi, L. (1989) Adenotonsillectomy. a safe outpatient procedure. Archives of Otolaryngology, Head and Neck Surgery 115: 92–94.CrossRefGoogle ScholarPubMed
Martindale, The extra pharmacopoeia. (1989) 29th Edition, (Reynolds, J. E., Parfitt, K., Parsons, A. V., Sweetman, S. C., eds.). Pharmaceutical press, London. pp 779, 1111–1112, 1186, 1547–1548.Google Scholar
Milford, C. A., Sudderick, R. M., Bleach, N. R., O'Flynn, P. E., Mugliston, T. A., Hadley, J. (1990) The influence of calcium alginate haemostatic swabs upon operative blood loss in adenotonsillectomy. Clinical Otolarygnology 15: 303–306.CrossRefGoogle ScholarPubMed
Shalom, A. S. (1964) Blood loss in ear, nose and throat operations. Journal of Larvngology and Otology 78: 734–756.Google Scholar
Sharp, J. F., Rogers, M. J. C., Kerr, A. I. G. (1991)The role of calcium alginate swabs in tonsillectomy. Clinical Otolarvngology 16: 319.Google Scholar
Thorisdottir, H., Ratnoff, O. D., Maniglia, A. J. (1988) Activation of Hageman factor (Factor XII) by bismuth subgallate, a hemostatic agent. Journal of Laboratory and Clinical Medicine 112: 1243–1247.Google Scholar
Thornton, J. A. (1963) Estimation of blood loss during surgery. Annals of the Royal College of Surgeons in England 33: 164–174.Google ScholarPubMed