耳部整形手术中区域神经阻滞的麻醉和镇痛效果。

Anesthetic and Analgesic Efficient of Regional Nerve Blockade in Otoplasty.

机构信息

Yeni Yuzyil University, Health Occupation High-School Anesthesia.

Meltem Hospital, Department of Anesthesia.

出版信息

J Craniofac Surg. 2020 Oct;31(7):1951-1954. doi: 10.1097/SCS.0000000000006501.

DOI:10.1097/SCS.0000000000006501

PMID:32371690

Abstract

AIM

The prominent ear is the most common congenital deformity of the external ear. Otoplasty is performed to correct the appearance of the prominent ear. This study was planned to compare the analgesic and anesthetic effects of local nerve blockade and local infiltration anesthesia in the otoplasties.

METHOD

Thirty-two patients who underwent otoplasty in both ears between February 2018 and March 2019 were included in the study. Three patients were excluded because they refused regional anesthesia. In the patients included in the study, only local infiltration anesthesia was applied to 1 ear and regional nerve blockade was applied to the other ear. Regional nerve blockade was applied to the study group; local infiltration anesthesia was applied to the control group. Surgical and anesthetic complications were recorded. The onset time, duration and severity of pain were followed. Numerical evaluation scale scores were used to evaluate pain levels.

RESULTS

It was observed that the first pain of the patients On the side where regional nerve block (RNB) anesthesia was applied after an average of 10.5 hours. On the other hand on the side where local infiltration anesthesia was applied; the pain was observed to start after an average of 3.5 hours. At the 6th and 12th hours postoperatively, the scores of the numerical evaluation scale were significantly lower in the study group than the control group (P < 0.05). At the 24th-hour pain score, the values were lower in the study group, but the difference was not significant between the groups (P > 0.05). In the regional anesthesia group, can develop such as difficulty in swallowing, weakness in the neck, weakness in the upper extremity, nausea, Horner syndrome; but all side effects resolve spontaneously within 6 to 12 hours.

CONCLUSION

The application of regional anesthesia in prominent ear surgical procedures can be considered as an alternative method to provide better quality preoperative anesthesia and better quality postoperative analgesia in patients.

摘要

目的

招风耳是最常见的外耳先天性畸形。耳成形术用于矫正招风耳的外观。本研究旨在比较局部神经阻滞和局部浸润麻醉在耳成形术中的镇痛和麻醉效果。

方法

2018 年 2 月至 2019 年 3 月间，我们对 32 例双耳接受耳成形术的患者进行了研究。有 3 例患者因拒绝区域麻醉而被排除在外。在纳入研究的患者中，一侧耳应用局部浸润麻醉，另一侧耳应用区域神经阻滞。区域神经阻滞应用于研究组；局部浸润麻醉应用于对照组。记录手术和麻醉并发症。随访疼痛的起始时间、持续时间和严重程度。采用数字评估量表评分评估疼痛程度。

结果

观察到，接受区域神经阻滞（RNB）麻醉的患者，其疼痛的第一时间平均为 10.5 小时后。另一方面，在接受局部浸润麻醉的一侧，疼痛平均在 3.5 小时后开始出现。术后 6 小时和 12 小时，研究组的数字评估量表评分明显低于对照组（P<0.05）。在术后 24 小时疼痛评分时，研究组的数值较低，但组间差异无统计学意义（P>0.05）。在区域麻醉组中，可能会出现吞咽困难、颈部无力、上肢无力、恶心、霍纳综合征等，但所有副作用均在 6 至 12 小时内自发缓解。