Yim MT, et al. - This trial inspected the real-time effects of the topical 1:1000 epinephrine in endoscopic sinus and skull-base surgery from systemic absorption, on the cardiovascular variations. The intranasal topical 1:1000 epinephrine use did not exhibit any prominent hemodynamic changes in the maximum patients. Nevertheless, in a subset of patients, it could lead to notable transient elevations in blood pressure to a degree that warranted intervention. A judicious use of topical epinephrine was recommended, in endoscopic sinus surgery.