University of California San Diego Department of Surgery, Division of Otolaryngology, San Diego, CA, USA.
University of California San Diego Department of Surgery, Division of Otolaryngology, San Diego, CA, USA.
Int J Pediatr Otorhinolaryngol. 2022 Jan;152:110976. doi: 10.1016/j.ijporl.2021.110976. Epub 2021 Nov 11.
To assess the effect of local anesthetic injection on post-operative analgesia and complications for pediatric tonsillectomies on post-operative day (POD) 0 and 1.
A 2-researcher team following the PRISMA guidelines performed a systematic review and meta-analysis. The databases Pubmed.gov, Embase, Web of Science, and Scopus were used. Studies written with original data utilizing a saline injection control arm were selected. Corresponding authors were contacted for missing data, which was used when possible. The collated data was analyzed with Review Manager (RevMan) Version 5.4., The Cochrane Collaboration, 2020. Surgical technique subgroup analysis was performed.
319 publications were identified and 8 articles with 12 total experimental arms (529 participants) were selected. Local anesthetic injection was compared to saline injection. The standard mean difference for time until first analgesic was 0.68 min [0.26, 1.09](P = 0.001) in favor of local anesthetic. The odds ratio (OR) for patients receiving one or more narcotic doses on POD 0 was 0.22 [0.06, 0.84](P = 0.03) in favor of local anesthetic.
Use of an intraoperative anesthetic injection during pediatric tonsillectomy can help improve initial recovery as it delays the need for narcotic medication and may reduce postoperative narcotic usage on POD 0 and 1. In addition, a local anesthetic does not increase the risk of postoperative bleeding or dehydration.
评估局部麻醉注射对小儿扁桃体切除术术后第 0 天和第 1 天的术后镇痛和并发症的影响。
一个由 2 名研究人员组成的团队遵循 PRISMA 指南进行了系统评价和荟萃分析。使用了 Pubmed.gov、Embase、Web of Science 和 Scopus 数据库。选择了使用生理盐水注射对照臂的具有原始数据的研究。对于缺失数据，联系了相应的作者，尽可能使用这些数据。使用 Review Manager（RevMan）Version 5.4 分析了整理后的数据，Cochrane 协作组织，2020 年。进行了手术技术亚组分析。
共确定了 319 篇出版物，选择了 8 篇文章的 12 个实验臂（529 名参与者）。将局部麻醉注射与生理盐水注射进行了比较。首次使用镇痛药的时间的标准均数差为 0.68 分钟[0.26，1.09]（P=0.001），局部麻醉更有利。术后第 0 天接受 1 次或更多次麻醉剂量的患者的优势比（OR）为 0.22 [0.06，0.84]（P=0.03），局部麻醉更有利。
在小儿扁桃体切除术中使用术中麻醉注射可以帮助改善初始恢复，因为它延迟了使用麻醉药物的需要，并且可能减少术后第 0 天和第 1 天的术后麻醉药物使用。此外，局部麻醉不会增加术后出血或脱水的风险。
