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 surgical field can be optimized by several techniques such as controlled hypotension, and local vasoconstrictors application, however, none of them can stand alone as a perfect choice for a bloodless surgical field. The hemostatic effect of intranasal desmopressin on the quality of the surgical field was investigated in patients undergoing endoscopic sinus surgery and revealed that desmopressin could reduce intraoperative bleeding. Hemostatic effects of desmopressin can be attributed to the rising in plasma levels of von Willebrand factor, coagulation factor VII and tissue plasminogen activator. Desmopressin also can play a role in improving platelet adhesiveness and stability of vascular endothelium. The topical application of 1:100,000 epinephrine is a common practice for intranasal surgical procedures. It decreases blood loss and improves endoscopic visualization. Up till now, no study compares nasal desmopressin and topical epinephrine effects on surgical field clarity and hemodynamics.
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.