The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain after septal surgery.
analgesia
bupivacaine
pain
septoplasty
sphenopalatine ganglion block
Journal
International forum of allergy & rhinology
ISSN: 2042-6984
Titre abrégé: Int Forum Allergy Rhinol
Pays: United States
ID NLM: 101550261
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
06
07
2019
revised:
31
07
2019
accepted:
01
08
2019
pubmed:
6
9
2019
medline:
2
6
2020
entrez:
6
9
2019
Statut:
ppublish
Résumé
This study evaluated the effect of bilateral endoscopic sphenopalatine ganglion block (SPGB) for management of postoperative pain in patients undergoing septoplasty. Sixty septoplasty patients (51.7% male, 48.3% female, aged 18 to 45 years) were randomly assigned to general anesthesia (GA) alone (control) (n = 30) or GA plus endoscopic SPGB (n = 30). Demographic data, duration of surgery, blood loss, postoperative visual analogue scale (VAS) pain scores (upon arrival at the postanesthesia care unit [PACU] and 2, 6, 12, and 24 hours after surgery), overall analgesic usage (end of 24 and 168 hours after surgery), overall satisfaction with the pain control (end of 24 and 168 hours after surgery), and complications (bleeding, nausea and vomiting, and visual disturbance) were recorded. Pain scores upon arrival to the PACU and 2, 6, 12, and 24 hours after surgery were significantly lower in the SPGB group compared to the control group (p < 0.001). Moreover, the SPGB group had significantly lower analgesic requirements and higher satisfaction scores with their pain control at the end of 24 and 168 hours after surgery compared to the control group (p < 0.001). The 2 groups significantly differed in terms of intraoperative blood loss (p = 0.024), and surgery time was longer in the SPGB group compared to the control group (p < 0.001). SPGB with bupivacaine is a safe and effective method to reduce pain after septoplasty, and it is a cost-effective alternative to high doses of analgesics.
Sections du résumé
BACKGROUND
This study evaluated the effect of bilateral endoscopic sphenopalatine ganglion block (SPGB) for management of postoperative pain in patients undergoing septoplasty.
METHODS
Sixty septoplasty patients (51.7% male, 48.3% female, aged 18 to 45 years) were randomly assigned to general anesthesia (GA) alone (control) (n = 30) or GA plus endoscopic SPGB (n = 30). Demographic data, duration of surgery, blood loss, postoperative visual analogue scale (VAS) pain scores (upon arrival at the postanesthesia care unit [PACU] and 2, 6, 12, and 24 hours after surgery), overall analgesic usage (end of 24 and 168 hours after surgery), overall satisfaction with the pain control (end of 24 and 168 hours after surgery), and complications (bleeding, nausea and vomiting, and visual disturbance) were recorded.
RESULTS
Pain scores upon arrival to the PACU and 2, 6, 12, and 24 hours after surgery were significantly lower in the SPGB group compared to the control group (p < 0.001). Moreover, the SPGB group had significantly lower analgesic requirements and higher satisfaction scores with their pain control at the end of 24 and 168 hours after surgery compared to the control group (p < 0.001). The 2 groups significantly differed in terms of intraoperative blood loss (p = 0.024), and surgery time was longer in the SPGB group compared to the control group (p < 0.001).
CONCLUSION
SPGB with bupivacaine is a safe and effective method to reduce pain after septoplasty, and it is a cost-effective alternative to high doses of analgesics.
Substances chimiques
Analgesics
0
Bupivacaine
Y8335394RO
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1521-1525Informations de copyright
© 2019 ARS-AAOA, LLC.
Références
Nguyen BK, Yuhan BT, Folbe E, et al. Perioperative analgesia for patients undergoing septoplasty and rhinoplasty: an evidence-based review. Laryngoscope. 2019;129:200-212.
Chen N, Soneru C, Kacker A. Does a single dose of pregabalin help with postoperative pain after septoplasty? Laryngoscope. 2018;128:1023-1024.
Riley CA, Kim M, Sclafani AP, et al. Opioid analgesic use and patient-reported pain outcomes after rhinologic surgery. Int Forum Allergy Rhinol. 2019;9:339-344.
Caliskan E, Sener M, Kipri M, et al. Comparison of the effects of intravenous dexketoprofen trometamol versus paracetamol on postoperative analgesia in patients undergoing septoplasty: a randomised double-blind clinical trial. Pak J Med Sci. 2018;34:546-552.
Al-Qudah M. Endoscopic sphenopalatine ganglion blockade efficacy in pain control after endoscopic sinus surgery. Int Forum Allergy Rhinol. 2016;6:334-338.
Cho DY, Drover DR, Nekhendzy V, et al. The effectiveness of preemptive sphenopalatine ganglion block on postoperative pain and functional outcomes after functional endoscopic sinus surgery. Int Forum Allergy Rhinol. 2011;1:212-218.
Rezaeian A, Hashemi SM, Dokhanchi ZS. Effect of sphenopalatine ganglion block with bupivacaine on postoperative pain in patients undergoing endoscopic sinus surgery. Allergy Rhinol (Providence). 2019;10:1-5.
DeMaria S Jr, S Govindaraj, Chinosorvatana N, et al. Bilateral sphenopalatine ganglion blockade improves postoperative analgesia after endoscopic sinus surgery. Am J Rhinol Allergy. 2012;26:23-27.
Robbins MS, Robertson CE, Kaplan E, et al. The sphenopalatine ganglion: anatomy, pathophysiology, and therapeutic targeting in headache. Headache. 2016;56:240-258.
Fujiwara T, Kuriyama A, Kato Y, et al. Perioperative local anaesthesia for reducing pain following septal surgery. Cochrane Database Syst Rev. 2018;23;8.
Sclafani AP, Kim M, Kjaer K, et al. Postoperative pain and analgesic requirements after septoplasty and rhinoplasty. Laryngoscope. 2019;129:2020-2025.
American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012;116:248-273.
Kesimci E, Öztürk L, Bercin S, et al. Role of sphenopalatine ganglion block for postoperative analgesia after functional endoscopic sinus surgery. Eur Arch Otorhinolaryngol. 2012;269:165-169.
Borodulin VG, Filimonov SV. The blockade of sphenopalatine ganglion through the palatal approach in the present-day rhinological practice. Vestn Otorinolaringol. 2016;81:38-41.
Dadgarnia MH, Shahbazian H, Behniafard N, et al. Epinephrine injection in greater palatine canal: an alternative technique for reducing hemorrhage during septoplasty. J Craniofac Surg. 2016;27:548-551.