Rajapakse Yosanta, Courtney Mark, Bialostocki Adam, Duncan Gary, Morrissey Graham
Otorhinolaryngology Unit, Head and Neck Unit, Capital Coast and District Health Board, Wellington, New Zealand.
ANZ J Surg. 2003 Jun;73(6):396-9. doi: 10.1046/j.1445-2197.2003.t01-1-02615.x.
The objective of the present study was to examine the outcome of nasal fracture reduction under both local anaesthesia and general anaesthesia techniques.
Patient records were obtained from clinic lists of patients attending the otolaryngology (ORL) outpatient unit at Wellington Hospital or the plastic surgical unit at Hutt Hospital over a 24-month period. To meet criteria for inclusion, patients had to have an isolated nasal deformity, be aged 14 years or older and be at least 6 months post reduction. Functional and aesthetic results were assessed using subjective and objective end outcome measures. A questionnaire was developed and used to assess subjective outcomes. The number of patients proceeding to open operative correction was used for the objective measure, which included septoplasty, septorhinoplasty or rhinoplasty.
A total of 197 patients had nasal fractures manipulated over this period. One hundred and seven were manipulated under general anaesthesia (GA) and 90 were manipulated under local anaesthesia (LA). The questionnaire completion rate was 66%. Patient demographics were statistically similar between the two groups. There was no statistical difference in patients" subjective assessment of outcome with treatment by GA or LA. More patients preferred to have their fracture manipulated under GA but this was not statistically significant. There was no significant difference between GA and LA groups in progression to open operative correction.
Both LA and GA appear to be acceptable and satisfactory methods of anaesthesia in the reduction of simple displaced nasal fracture.
本研究的目的是探讨局部麻醉和全身麻醉技术下鼻骨骨折复位的效果。
从惠灵顿医院耳鼻喉科(ORL)门诊或哈特医院整形外科24个月期间的患者临床记录中获取患者信息。为符合纳入标准,患者必须有孤立性鼻畸形,年龄在14岁及以上,且复位后至少6个月。使用主观和客观的最终结局指标评估功能和美学效果。设计了一份问卷并用于评估主观结局。采用进行开放性手术矫正的患者数量作为客观指标,包括鼻中隔成形术、鼻 septorhinoplasty或鼻成形术。
在此期间,共有197例患者接受了鼻骨骨折整复。107例在全身麻醉(GA)下进行整复,90例在局部麻醉(LA)下进行整复。问卷完成率为66%。两组患者的人口统计学特征在统计学上相似。患者对GA或LA治疗结局的主观评估无统计学差异。更多患者倾向于在GA下进行骨折整复,但这在统计学上不显著。GA组和LA组在进展为开放性手术矫正方面无显著差异。
在单纯移位性鼻骨骨折复位中,LA和GA似乎都是可接受且令人满意的麻醉方法。