Abubaker Ahmad K, Al-Qudah Mohannad A
1 Department of Anesthesia and Recovery, Jordan University of Science and Technology, Irbid, Jordan.
2 Department of Special Surgery, Division of ORL-HNS, Jordan University of Science and Technology, Irbid, Jordan.
Am J Rhinol Allergy. 2018 Sep;32(5):369-373. doi: 10.1177/1945892418782235. Epub 2018 Jun 27.
Background Postoperative nausea and vomiting (PONV) are among the most common unpleasant and distressing adverse events following surgery under general anesthesia. Functional endoscopic sinus surgery (FESS) is a common otolaryngology procedure. Prevention of PONV and early recovery are cost-effective. Objective The aim of this study was to evaluate the prophylactic effect of bilateral endoscopic injection of lidocaine with epinephrine in the sphenopalatine ganglion (SPG) on PONV in patients undergoing FESS. Methods One hundred patients with chronic rhinosinusitis undergoing general anesthesia for FESS were enrolled in this double-blind, placebo-controlled study. Patients were randomized to receive injection of 2 mL of 2% lidocaine with epinephrine or 2 mL of saline at the end of surgery. Postoperatively, patients were observed for 24 h. PONV was evaluated immediately, 6 h, and 24 h after surgery. Results The 2 groups were comparable in characteristic and intraoperative features. In general, the incidence of PONV after FESS was 36%. The average time that patients can tolerate oral feeding was 3.4 h after surgery. Endoscopic SPG injection with lidocaine significantly reduced the incidence of vomiting and PONV. In addition, SPG injection with lidocaine reduced the incidence of severe vomiting and decreased the number of vomiting episodes. No complications were encountered in either group. Conclusion SPG injection with lidocaine at the end of surgery is a safe, noninvasive, and an effective technique in reducing early PONV in endoscopic sinus surgery patients.
术后恶心呕吐（PONV）是全身麻醉手术后最常见的令人不适和痛苦的不良事件之一。功能性鼻内镜鼻窦手术（FESS）是一种常见的耳鼻喉科手术。预防PONV和促进早期恢复具有成本效益。目的：本研究旨在评估双侧蝶腭神经节（SPG）内镜注射利多卡因加肾上腺素对接受FESS患者PONV的预防效果。方法：本双盲、安慰剂对照研究纳入了100例因FESS接受全身麻醉的慢性鼻窦炎患者。患者在手术结束时随机接受注射2 mL含肾上腺素的2%利多卡因或2 mL生理盐水。术后观察患者24小时。在术后即刻、6小时和24小时评估PONV。结果：两组在特征和术中情况方面具有可比性。一般来说，FESS后PONV的发生率为36%。患者术后能耐受经口进食的平均时间为3.4小时。内镜下SPG注射利多卡因显著降低了呕吐和PONV的发生率。此外，SPG注射利多卡因降低了严重呕吐的发生率并减少了呕吐发作次数。两组均未出现并发症。结论：手术结束时SPG注射利多卡因是一种安全、无创且有效的降低内镜鼻窦手术患者早期PONV的技术。
