Anemization

Anemization is a therapeutic and diagnostic procedure in which temporary, localized ischemia (devascularization) of the mucous membrane is induced with topical vasoconstrictors.

The primary objective of this technique is to reduce mucosal hyperemia and edema. This measure facilitates surgical interventions, improves visualization during examinations, and enhances the efficacy of local anesthetics. Anemization is most commonly employed in otolaryngology and dentistry.

Technique and Mechanism of Action

The procedure is performed by applying a cotton swab or turunda soaked in a vasoconstrictor solution to the target mucosal area (e.g., the nasal cavity). Its mechanism of action is based on stimulation of alpha-adrenergic receptors in the walls of small arteries and arterioles, leading to vasospasm and a marked reduction in local blood flow.

Commonly used agents include:

• Epinephrine (adrenaline) solution. The drug provides the most potent and rapid, though short-term, vasoconstrictive effect.
• Imidazoline derivatives. This group includes widely used nasal decongestants such as xylometazoline and oxymetazoline.

Clinical Significance

In clinical practice, anemization serves to:

• Reduce tissue bleeding during surgery (e.g., septoplasty or endoscopic sinus surgery).
• Improve visibility of anatomical structures during diagnostic endoscopy.
• Prolong local anesthetic effects by slowing systemic absorption.

Despite its topical application, systemic absorption of vasoconstrictors may occur, potentially leading to adverse effects such as tachycardia and elevated blood pressure. Therefore, the procedure is contraindicated in patients with severe arterial hypertension, thyrotoxicosis, or angle-closure glaucoma.