Atighechi Saeid, Baradaranfar Mohammad Hossein, Akbari Sureh Allaf
Department of Otolaryngology and Head and Neck Surgery, Yazd University of Medical Sciences, Yazd, Iran.
J Craniofac Surg. 2009 Mar;20(2):382-4. doi: 10.1097/SCS.0b013e31819b945f.
The aim of the current study of nasal bone fracture reduction carried out under topical, local, and general anesthesia was to suggest a proper treatment of patients with nose fractures.
The patient candidates for close nasal bone reduction (CNR) were divided into 3 groups: topical anesthesia (TA), local anesthesia (LA), and general anesthesia (GA), and CNR was performed. After reduction, pain scores and satisfaction and failure rates after 2 and 30 days were noted. All the patients were followed up for at least 1 month.
The mean pain scores (TA = 2.35, LA = 2.47, and GA = 1.9) showed no significant difference among these 3 groups (P > 0.05). The percentages of the patients' satisfaction in the groups were as follows: TA = 84.6%, LA = 83.8%, and GA = 91.7%. These values had no statistical difference (P > 0.05). There was no significant difference among the failure rates on the second day and after 1 month of follow-up (after 2 d, TA = 10%, LA = 18%, and GA = 14%, and after 1 month, TA = 2%, LA = 7%, and GA = 5%).
If the selection of patients is done properly, CNR under TA/LA will have considerable success in comparison with GA. Topical anesthesia is suggested in simple nasal fracture with unilateral depression or minimal displacement.
本研究旨在探讨在局部、区域和全身麻醉下进行鼻骨骨折复位的方法，以提出对鼻骨骨折患者的合适治疗方案。
将适合闭合性鼻骨复位（CNR）的患者分为3组：局部麻醉（TA）组、区域麻醉（LA）组和全身麻醉（GA）组，并进行CNR。复位后，记录2天和30天后的疼痛评分、满意度及失败率。所有患者至少随访1个月。
这3组的平均疼痛评分（TA = 2.35，LA = 2.47，GA = 1.9）无显著差异（P > 0.05）。各组患者的满意度百分比分别为：TA = 84.6%，LA = 83.8%，GA = 91.7%。这些数值无统计学差异（P > 0.05）。随访第2天和1个月后的失败率无显著差异（随访2天后，TA = 10%，LA = 18%，GA = 14%；随访1个月后，TA = 2%，LA = 7%，GA = 5%）。
如果患者选择得当，与全身麻醉相比，局部/区域麻醉下的CNR将取得相当大的成功。对于单侧凹陷或移位极小的单纯鼻骨骨折，建议采用局部麻醉。
