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在鼻中隔成形术中,将眶下神经和滑车下神经联合阻滞添加到全身麻醉中的效果。

Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty.

作者信息

Kaçar Cem Kıvılcım, Uzundere Osman, Salık Fikret, Akgündüz Mesut, Bıçak Esra Aktiz, Yektaş Abdulkadir

机构信息

Anaesthesiology and Reanimation Clinic, Gazi Yaşargil Education and Research Hospital, TR Health Sciences University, Diyarbakır, Turkey.

出版信息

J Pain Res. 2020 Oct 14;13:2599-2607. doi: 10.2147/JPR.S255720. eCollection 2020.

Abstract

PURPOSE

In this study, we evaluated the hypothesis that preoperative bilateral infraoptic nerve (ION) and infratrochlear nerve (ITN) blocks under general anesthesia with sevoflurane and remifentanil reduced the incidence of emergence agitation (EA), pain scores, and the analgesic consumption after the septorhinoplasty.

PATIENTS AND METHODS

Our study was conducted as a prospective randomized, double-sided blind study. Fifty-two patients whose septorhinoplasty operation was planned under general anesthesia were included in the study. Patients were randomly distributed to either the ION and ITN blocks were performed. Group 1: Bilateral ION and ITN blocks were performed; Group 2: ION and ITN blocks were not performed. Duration of the surgery and anesthesia, Riker Sedation-Agitation Scale (RSAS) score, EA presence, duration of postoperative analgesia, numerical rating scale (NRS) scores, and cumulative dexketoprofen consumption were recorded.

RESULTS

The RSAS score, NRS score and cumulative dexketoprofen consumption of the patients in Group 1 were statistically significantly lower than the patients in Group 2 (p<0.05). It was also found that patients in Group 1 (n: 8/26) had less EA compared to patients in Group 2 (n: 16/26) and this difference was statistically significant (p: 0.026). Postoperative analgesia duration of patients in Group 1 was found to be statistically significantly higher than patients in Group 2 (p: <0.001). In addition, the number of patients given postoperative dexketoprofen in Group 1 (n: 8/26) was found to be statistically significantly lower than patients in Group 2 (n: 25/26). (p: <0.001).

CONCLUSION

Bilateral ION and ITN blocks in septorhinoplasty operation is an effective, reliable and simple technique in the treatment of postoperative pain.

摘要

目的

在本研究中,我们评估了以下假设:在七氟醚和瑞芬太尼全身麻醉下进行术前双侧眶下神经(ION)和滑车下神经(ITN)阻滞可降低鼻中隔成形术后苏醒期躁动(EA)的发生率、疼痛评分以及镇痛药物的消耗量。

患者与方法

我们的研究作为一项前瞻性随机、双盲研究进行。纳入了52例计划在全身麻醉下进行鼻中隔成形术的患者。患者被随机分为两组,分别进行ION和ITN阻滞。第1组:进行双侧ION和ITN阻滞;第2组:不进行ION和ITN阻滞。记录手术和麻醉持续时间、里克尔镇静 - 躁动量表(RSAS)评分是否存在EA、术后镇痛持续时间、数字评分量表(NRS)评分以及右酮洛芬的累积消耗量。

结果

第1组患者的RSAS评分、NRS评分和右酮洛芬累积消耗量在统计学上显著低于第2组患者(p<0.05)。还发现第1组患者(n: 8/26)发生EA的情况少于第2组患者(n: 16/26),且这种差异具有统计学意义(p: 0.026)。发现第1组患者的术后镇痛持续时间在统计学上显著长于第2组患者(p: <0.001)此外,第1组术后使用右酮洛芬的患者数量(n: 8/26)在统计学上显著低于第2组患者(n: 25/26)(p: <0.001)。

结论

鼻中隔成形术中双侧ION和ITN阻滞是治疗术后疼痛的一种有效、可靠且简单的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5263/7569075/ed11ed02f52a/JPR-13-2599-g0001.jpg

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