The effect of nasal application of cocaine/adrenaline on blood loss in Le Fort I osteotomies

Cocaine is a very potent vasoconstrictor that is used by ENT specialists to reduce blood loss and enhance visibility during nasal surgery. In orthognathic surgery, especially Le Fort I procedures, excessive blood loss is a relatively frequent complication. In this study, a prospective randomized clinical trial on the effect on blood loss of cocaine/adrenaline application to the nasal floor is presented. Thirty patients who underwent a Le Fort I procedure were randomized for cocaine/adrenaline application. Blood loss and duration of surgery were registered for both groups. The results showed a significant reduction of blood loss in the group with cocaine/adrenaline application (P < 0.001), but no significant difference in operating time. No side effects were observed. From this study, it can be concluded that the application of cocaine/adrenaline to the nasal floor is a safe procedure to reduce blood loss during a Le Fort I procedure.