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内镜蝶腭神经节阻滞在鼻中隔手术后疼痛管理中的效果。

The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain after septal surgery.

机构信息

Department of Otorhinolaryngology, Adana City Training and Research Hospital, Adana, Turkey.

出版信息

Int Forum Allergy Rhinol. 2019 Dec;9(12):1521-1525. doi: 10.1002/alr.22411. Epub 2019 Sep 5.

DOI:10.1002/alr.22411
PMID:31487422
Abstract

BACKGROUND

This study evaluated the effect of bilateral endoscopic sphenopalatine ganglion block (SPGB) for management of postoperative pain in patients undergoing septoplasty.

METHODS

Sixty septoplasty patients (51.7% male, 48.3% female, aged 18 to 45 years) were randomly assigned to general anesthesia (GA) alone (control) (n = 30) or GA plus endoscopic SPGB (n = 30). Demographic data, duration of surgery, blood loss, postoperative visual analogue scale (VAS) pain scores (upon arrival at the postanesthesia care unit [PACU] and 2, 6, 12, and 24 hours after surgery), overall analgesic usage (end of 24 and 168 hours after surgery), overall satisfaction with the pain control (end of 24 and 168 hours after surgery), and complications (bleeding, nausea and vomiting, and visual disturbance) were recorded.

RESULTS

Pain scores upon arrival to the PACU and 2, 6, 12, and 24 hours after surgery were significantly lower in the SPGB group compared to the control group (p < 0.001). Moreover, the SPGB group had significantly lower analgesic requirements and higher satisfaction scores with their pain control at the end of 24 and 168 hours after surgery compared to the control group (p < 0.001). The 2 groups significantly differed in terms of intraoperative blood loss (p = 0.024), and surgery time was longer in the SPGB group compared to the control group (p < 0.001).

CONCLUSION

SPGB with bupivacaine is a safe and effective method to reduce pain after septoplasty, and it is a cost-effective alternative to high doses of analgesics.

摘要

背景

本研究评估了双侧内镜蝶腭神经节阻滞(SPGB)在鼻中隔成形术后管理中的镇痛效果。

方法

将 60 例鼻中隔成形术患者(男性占 51.7%,女性占 48.3%,年龄 18-45 岁)随机分为单纯全身麻醉(GA)组(对照组)(n=30)或 GA 加内镜 SPGB 组(n=30)。记录患者的人口统计学数据、手术时间、术中出血量、术后视觉模拟评分(到达麻醉后恢复室[PACU]时和术后 2、6、12 和 24 小时)、总镇痛药物使用量(术后 24 和 168 小时结束时)、术后 24 和 168 小时对疼痛控制的总体满意度以及并发症(出血、恶心和呕吐、视觉障碍)。

结果

SPGB 组患者在到达 PACU 时以及术后 2、6、12 和 24 小时的疼痛评分明显低于对照组(p<0.001)。此外,与对照组相比,SPGB 组在术后 24 和 168 小时结束时镇痛药物需求较低,对疼痛控制的满意度较高(p<0.001)。两组在术中出血量方面存在显著差异(p=0.024),SPGB 组的手术时间也明显长于对照组(p<0.001)。

结论

布比卡因 SPGB 是一种安全有效的减轻鼻中隔成形术后疼痛的方法,是替代高剂量镇痛药的经济有效的方法。

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