Cook J A, McRae R D, Irving R M, Dowie L N
Department of Otolaryngology, St. Bartholomew's Hospital, London, UK.
Clin Otolaryngol Allied Sci. 1990 Aug;15(4):343-6. doi: 10.1111/j.1365-2273.1990.tb00480.x.
Reduction of simple nasal fractures may be performed under local or general anaesthesia: the latter is by far the most popular method in Britain, though why is hard to define. We have attempted to compare the 2 approaches by means of a randomized, prospective trial. Fifty consecutive, adult patients with radiologically proved fractures of the nasal bones were randomized to a local or general anaesthesia group and underwent manipulation with Asch's and Walsham's forceps between 7 and 15 days post-injury. Analysis of results at 4 h and 8 weeks post-operatively showed no significant benefit conferred by fracture reduction under general anaesthesia as opposed to local anaesthesia with respect to post-operative airway patency or cosmesis. It is suggested that significant benefits can be obtained in terms of patient convenience and cost effectiveness if nasal fractures are reduced under local anaesthesia as an outpatient procedure.
在英国，全身麻醉是目前最常用的方法，不过原因很难说清。我们试图通过一项随机前瞻性试验对这两种方法进行比较。连续50例经放射学证实鼻骨骨折的成年患者被随机分为局部麻醉组或全身麻醉组，并在受伤后7至15天使用阿施氏钳和瓦尔沙姆氏钳进行整复。术后4小时和8周的结果分析表明，与局部麻醉相比，全身麻醉下的骨折复位在术后气道通畅或美容方面并无显著益处。有人认为，如果在局部麻醉下作为门诊手术进行鼻骨骨折复位，在患者便利性和成本效益方面可获得显著益处。
