Abstract：
:The nasal mucosa is very vascular, receiving more blood flow per cubic centimeter of tissue than does muscle, brain or liver (Drettner and Aust, 1974; [1]). This vascularity can present a major problem during sinus surgery. Surgeons routinely use topical vasoconstrictors in endoscopic sinus surgery however, the optimal regimen is not clear. Imidazoline nasal sprays are often used up to 1hour before sinonasal surgery to aid in intraoperative vasoconstriction. After the induction of anaesthesia, epinephrine-based topical and submucosal preparations are subsequently administered to further enhance vasoconstriction. Imidazolines are non-selective, partial alpha adrenoceptor agonists with a higher affinity, yet lower potency, for alpha adrenoceptors when compared to epinephrine. It is hypothesized that imidazolines block the action of epinephrine on the alpha adrenoceptors of the nasal mucosa resulting in less vasoconstriction, and a poorer intra-operative field, when compared to the use of epinephrine alone. This paper hypothesizes that preoperative imidazoline administration may adversely affect optimal intra-operative vasoconstriction.
journal_name
Med Hypothesesjournal_title
Medical hypothesesauthors
Campbell RG,Nair S,Sacks R,Douglas RGdoi
10.1016/j.mehy.2014.03.009subject
Has Abstractpub_date
2014-06-01 00:00:00pages
706-8issue
6eissn
0306-9877issn
1532-2777pii
S0306-9877(14)00111-Xjournal_volume
82pub_type
杂志文章abstract：:It is proposed here that the initial events in gastric carcinogenesis occur at the junction of the oxyntic and antral mucosae. Intestinal metaplasia represents an adaptive counter-response to early neoplastic change at this site. Chronic gastric ulceration may arise due to the elimination of overtly dedifferentiated c...
journal_title：Medical hypotheses
pub_type： 杂志文章
doi：10.1016/0306-9877(91)90229-r
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pub_type： 杂志文章
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pub_type： 杂志文章
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