Delayed hemorrhage effect of local anesthesia with epinephrine in the loop electrosurgical excisional procedure.
- Author:
Yong Jae LEE
1
;
Yunjin PARK
;
In Ok LEE
;
Jung Won YOON
;
Jung Yoon LEE
;
Sang Wun KIM
;
Sunghoon KIM
;
Young Tae KIM
;
Eun Ji NAM
Author Information
- Publication Type:Original Article
- Keywords: Anesthesia, local; Delayed hemorrhage; Loop electrosurgical excisional procedure
- MeSH: Ambulatory Care Facilities; Anesthesia, General; Anesthesia, Local*; Emergency Service, Hospital; Epinephrine*; Fibrin Tissue Adhesive; Hemorrhage*; Humans; Medical Records; Operating Rooms
- From:Obstetrics & Gynecology Science 2017;60(1):87-91
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The aim of this study was to investigate factors preventing delayed hemorrhage after the loop electrosurgical excisional procedure (LEEP). METHODS: Medical records of patients who underwent LEEP at one university affiliated hospital from October 2013 to January 2015 were reviewed. Patients with or without delayed hemorrhage were classified. LEEP was performed either in an operating room under general anesthesia or in a procedure room with local anesthesia in the outpatient clinic. Delayed hemorrhage was defined as excisional site bleeding occurring between 1 and 30 days after the LEEP requiring intervention such as electro-cauterization, gauze packing, or application of another hemostatic agent. RESULTS: During the study period, 369 patients underwent LEEP. Twenty-three (6.2%) patients with delayed hemorrhage returned to our hospital either to the outpatient clinic or to the emergency unit. A third of the population (103, 27.9%) underwent LEEP in the operating room under general anesthesia without injection of local anesthesia. The remaining patients (266, 72.1%) underwent LEEP with local anesthesia (lidocaine HCl 2% with epinephrine 1:100,000) in the office procedure room. Patients given local anesthesia including epinephrine had significantly lower delayed hemorrhage compared to patients with general anesthesia without injection of local anesthesia (P=0.001). Hemostats, such as fibrin glue or patch, were used for the majority of patients (346, 93.8%) during the procedure. However, using hemostats was not statistically associated with delayed hemorrhage (P=0.163). CONCLUSION: Local anesthesia with the powerful vasoconstrictor epinephrine is effective not only to control perioperative bleeding, but also to prevent delayed hemorrhage after LEEP.
