Comparison of outcomes for general and local anesthesia in the management of nasal bone fractures: a meta-analysis.
General anesthesia
Local anesthesia
Meta-analysis
Nasal bone fracture
Surgery
Journal
European journal of medical research
ISSN: 2047-783X
Titre abrégé: Eur J Med Res
Pays: England
ID NLM: 9517857
Informations de publication
Date de publication:
02 Jun 2024
02 Jun 2024
Historique:
received:
02
01
2024
accepted:
21
05
2024
medline:
3
6
2024
pubmed:
3
6
2024
entrez:
2
6
2024
Statut:
epublish
Résumé
This meta-analysis aimed to perform a head-to-head comparison of the role of general anesthesia (GA) and local anesthesia (LA) in the management of patients with nasal bone fractures (NBFs). PubMed, Embase, and Web of Science were comprehensively searched. Studies investigating the clinical outcomes of GA and LA in the management of NBFs were included. Pooled odds ratios (OR) with the respective 95% confidence intervals (CIs) were calculated. Heterogeneity between the included studies was evaluated. The risk of bias in the included studies was assessed. Eight studies were included in this meta-analysis. The pooled ORs for cosmetic results, residual septal deformity, the need for further surgery, patients' satisfaction with the anesthesia procedure, and patients' satisfaction with the surgery results were 0.70 (95% CI 0.18, 2.64; z = - 0.53, p = 0.5957), 1.11 (95% CI 0.37, 3.30; z = 0.18, p = 0.8558), 1.19 (95% CI 0.65, 2.20; z = 0.56, p = 0.5760), 1.57 (95% CI 0.92, 2.69; z = 1.65, p = 0.0982), and 1.00 (95% CI 0.55, 1.80; z = - 0.00, p = 0.9974). Insignificant difference on clinical outcomes was observed between GA and LA in the manipulation of patients with NBFs, and the choice of anesthetic approach should be based on the tolerability of the methods and the severity of nasal fractures.
Sections du résumé
BACKGROUND
BACKGROUND
This meta-analysis aimed to perform a head-to-head comparison of the role of general anesthesia (GA) and local anesthesia (LA) in the management of patients with nasal bone fractures (NBFs).
METHODS
METHODS
PubMed, Embase, and Web of Science were comprehensively searched. Studies investigating the clinical outcomes of GA and LA in the management of NBFs were included. Pooled odds ratios (OR) with the respective 95% confidence intervals (CIs) were calculated. Heterogeneity between the included studies was evaluated. The risk of bias in the included studies was assessed.
RESULTS
RESULTS
Eight studies were included in this meta-analysis. The pooled ORs for cosmetic results, residual septal deformity, the need for further surgery, patients' satisfaction with the anesthesia procedure, and patients' satisfaction with the surgery results were 0.70 (95% CI 0.18, 2.64; z = - 0.53, p = 0.5957), 1.11 (95% CI 0.37, 3.30; z = 0.18, p = 0.8558), 1.19 (95% CI 0.65, 2.20; z = 0.56, p = 0.5760), 1.57 (95% CI 0.92, 2.69; z = 1.65, p = 0.0982), and 1.00 (95% CI 0.55, 1.80; z = - 0.00, p = 0.9974).
CONCLUSIONS
CONCLUSIONS
Insignificant difference on clinical outcomes was observed between GA and LA in the manipulation of patients with NBFs, and the choice of anesthetic approach should be based on the tolerability of the methods and the severity of nasal fractures.
Identifiants
pubmed: 38825676
doi: 10.1186/s40001-024-01896-3
pii: 10.1186/s40001-024-01896-3
doi:
Types de publication
Journal Article
Meta-Analysis
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
306Subventions
Organisme : Wuxi Double Hundred Top Talent Project
ID : BJ2020038
Informations de copyright
© 2024. The Author(s).
Références
Kelley BP, Downey CR, Stal S. Evaluation and reduction of nasal trauma. Semin Plast Surg. 2010;24(4):339–47.
doi: 10.1055/s-0030-1269763
pubmed: 22550458
pmcid: 3324218
Landeen KC, Kimura K, Stephan SJ. Nasal fractures. Facial Plast Surg Clin North Am. 2022;30(1):23–30.
doi: 10.1016/j.fsc.2021.08.002
pubmed: 34809884
Epstein S, Ettinger RE. Nasal and naso-orbito-ethmoid fractures. Semin Plast Surg. 2021;35(4):263–8.
doi: 10.1055/s-0041-1735791
pubmed: 34819808
pmcid: 8604621
Aydin Savas S, Aydin IE. The effect of a new topographic classification on determining the prognosis of nasal fracture and treatment modality. Ulus Travma ve Acil Cerrahi Derg = Turk J Trauma Emerg Surg TJTES. 2023;29(2):212–7.
Lu GN, Humphrey CD, Kriet JD. Correction of nasal fractures. Facial Plast Surg Clin North Am. 2017;25(4):537–46.
doi: 10.1016/j.fsc.2017.06.005
pubmed: 28941506
Mondin V, Rinaldo A, Ferlito A. Management of nasal bone fractures. Am J Otolaryngol. 2005;26(3):181–5.
doi: 10.1016/j.amjoto.2004.11.006
pubmed: 15858774
Basheeth N, Donnelly M, David S, Munish S. Acute nasal fracture management: a prospective study and literature review. Laryngoscope. 2015;125(12):2677–84.
doi: 10.1002/lary.25358
pubmed: 25959006
Chadha NK, Repanos C, Carswell AJ. Local anaesthesia for manipulation of nasal fractures: systematic review. J Laryngol Otol. 2009;123(8):830–6.
doi: 10.1017/S002221510900560X
pubmed: 19470190
Sindi A, Abaalkhail Y, Malas M, Alghamdi A, Joharji M. Patients with nasal fracture. J Craniofac Surg. 2020;31(3):e275–7.
doi: 10.1097/SCS.0000000000006269
pubmed: 32068733
Chung JH, Yeo HD, Yoon ES, Lee BI, Park SH. Comparison of the outcomes of closed reduction nasal bone fractures with a surgical navigation system. J Craniofac Surg. 2020;31(6):1625–8.
doi: 10.1097/SCS.0000000000006546
pubmed: 32433134
Cook JA, McRae RD, Irving RM, Dowie LN. A randomized comparison of manipulation of the fractured nose under local and general anaesthesia. Clin Otolaryngol Allied Sci. 1990;15(4):343–6.
doi: 10.1111/j.1365-2273.1990.tb00480.x
pubmed: 2225504
Watson DJ, Parker AJ, Slack RW, Griffiths MV. Local versus general anaesthetic in the management of the fractured nose. Clin Otolaryngol Allied Sci. 1988;13(6):491–4.
doi: 10.1111/j.1365-2273.1988.tb00323.x
pubmed: 3228992
Courtney MJ, Rajapakse Y, Duncan G, Morrissey G. Nasal fracture manipulation: a comparative study of general and local anaesthesia techniques. Clin Otolaryngol Allied Sci. 2003;28(5):472–5.
doi: 10.1046/j.1365-2273.2003.00754.x
pubmed: 12969353
Khwaja S, Pahade AV, Luff D, Green MW, Green KM. Nasal fracture reduction: local versus general anaesthesia. Rhinology. 2007;45(1):83–8.
pubmed: 17432077
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372: n71.
doi: 10.1136/bmj.n71
pubmed: 33782057
pmcid: 8005924
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA. The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343: d5928.
doi: 10.1136/bmj.d5928
pubmed: 22008217
pmcid: 3196245
Stang A. Critical evaluation of the newcastle-ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.
doi: 10.1007/s10654-010-9491-z
pubmed: 20652370
Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, Thomas J. Updated guidance for trusted systematic reviews: a edition new of the cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev. 2019;10:Ed000142.
pubmed: 31643080
Kyung H, Choi JI, Song SH, Oh SH, Kang N. Comparison of postoperative outcomes between monitored anesthesia care and general anesthesia in closed reduction of nasal fracture. J Craniofac Surg. 2018;29(2):286–8.
doi: 10.1097/SCS.0000000000004084
pubmed: 29084114
Atighechi S, Baradaranfar MH, Akbari SA. Reduction of nasal bone fractures: a comparative study of general, local, and topical anesthesia techniques. J Craniofac Surg. 2009;20(2):382–4.
doi: 10.1097/SCS.0b013e31819b945f
pubmed: 19258905
Ridder GJ, Boedeker CC, Fradis M, Schipper J. Technique and timing for closed reduction of isolated nasal fractures: a retrospective study. Ear Nose Throat J. 2002;81(1):49–54.
doi: 10.1177/014556130208100116
pubmed: 11816391
Waldron J, Mitchell DB, Ford G. Reduction of fractured nasal bones; local versus general anaesthesia. Clin Otolaryngol Allied Sci. 1989;14(4):357–9.
doi: 10.1111/j.1365-2273.1989.tb00384.x
pubmed: 2805375
Zhang P, Zhao J, Zang M, Gao H, Wang X, Mu J. Etiology of nasal bone fracture: a retrospective analysis of 1,441 patients in China. J Craniofac Surg. 2022;33(4):1185–9.
doi: 10.1097/SCS.0000000000008479
pubmed: 36041112
Pérez-García A, Esteban-Vico JR, Lorca-García C, García-Sánchez JM, Miranda Gómez L, Llinás Porte A, García-Sanz P. Endonasal infiltrative anesthesia for nasal fracture reduction. Plast Surg Nurs. 2019;39(1):22–4.
doi: 10.1097/PSN.0000000000000248
pubmed: 30801495
Hwang K, Yeom SH, Hwang SH. Complications of nasal bone fractures. J Craniofac Surg. 2017;28(3):803–5.
doi: 10.1097/SCS.0000000000003482
pubmed: 28468171
Green KM. Reduction of nasal fractures under local anaesthetic. Rhinology. 2001;39(1):43–6.
pubmed: 11340695
Rajapakse Y, Courtney M, Bialostocki A, Duncan G, Morrissey G. Nasal fractures: a study comparing local and general anaesthesia techniques. ANZ J Surg. 2003;73(6):396–9.
doi: 10.1046/j.1445-2197.2003.t01-1-02615.x
pubmed: 12801336
Rohrich RJ, Adams WP Jr. Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg. 2000;106(2):266–73.
doi: 10.1097/00006534-200008000-00003
pubmed: 10946923
Al-Moraissi EA, Ellis E 3rd. Local versus general anesthesia for the management of nasal bone fractures: a systematic review and meta-analysis. J Oral Maxillofac Surg. 2015;73(4):606–15.
doi: 10.1016/j.joms.2014.10.013
pubmed: 25577456
Kelly E. In regard to local versus general anesthesia for the management of nasal bone fractures: a systematic review and meta-analysis. J Oral Maxillofac Surg. 2016;74(6):1105–6.
doi: 10.1016/j.joms.2016.01.045
pubmed: 26917202