Effects of saline irrigation at various temperatures on bleeding in adenoidectomy

Objective: To evaluate the efficacy of saline irrigation for hemostasis during adenoidectomy, comparing hot (50 degrees C), room temperature (25 degrees C), and cold (4 degrees C) saline. Material and methods: This randomized prospective controlled study included 120 consecutive patients with adenoid hypertrophy. Saline irrigation was used to achieve hemostasis during adenoidectomy. Patients were randomly divided into three groups: group 1 (cold saline, 4 degrees C), group 2 (warm saline, 25 degrees C), and group 3 (hot saline, 50 degrees C). Hemostasis and operation times of the patients were compared according to irrigation temperature, sex, adenoid grade, and indication for surgery. Result: Sixty-two (51.7%) of the patients were male while 58 (48.3%) were female. The mean age of the patients was 6 +/- 1 years. Among them, 22 (18.3%) patients had grade 2, 53 (44.2%) had grade 3, and 45 (37.5%) had grade 4 adenoid hypertrophy. There were 83 (69.2%) patients who had the operation for choanal obstruction and 37 (30.8%) who had the operation for chronic adenoiditis. Hemostasis and operation times significantly differed only by irrigation temperature, being the shortest in group 3 and longest in group 2. In addition, there was a positive correlation between hemostasis time and operation time (P < 0.001). Conclusion: Saline irrigation was an effective hemostatic agent during adenoidectomy, and hot saline was more effective than either room-temperature or cold saline.