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眶下神经和/或滑车神经阻滞对鼻整形术后患者术后护理的影响:一项荟萃分析。

Effect of Infraorbital and/or Infratrochlear Nerve Blocks on Postoperative Care in Patients with Septorhinoplasty: A Meta-Analysis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

出版信息

Medicina (Kaunas). 2023 Sep 14;59(9):1659. doi: 10.3390/medicina59091659.

Abstract

: Through a comprehensive meta-analysis of the pertinent literature, this study evaluated the utility and efficacy of perioperative infraorbital and/or infratrochlear nerve blocks in reducing postoperative pain and related morbidities in patients undergoing septorhinoplasty. : We reviewed studies retrieved from the PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases up to August 2023. The analysis included a selection of seven articles that compared a treatment group receiving perioperative infraorbital and/or infratrochlear nerve blocks with a control group that either received a placebo or no treatment. The evaluated outcomes covered parameters such as postoperative pain, the amount and frequency of analgesic medication administration, the incidence of postoperative nausea and vomiting, as well as the manifestation of emergence agitation. : The treatment group displayed a significant reduction in postoperative pain (mean difference = -1.7236 [-2.6825; -0.7646], I = 98.8%), as well as a significant decrease in both the amount (standardized mean difference = -2.4629 [-3.8042; -1.1216], I = 93.0%) and frequency (odds ratio = 0.3584 [0.1383; 0.9287], I = 59.7%) of analgesic medication use compared to the control. The incidence of emergence agitation (odds ratio = 0.2040 [0.0907; 0.4590], I = 0.0%) was notably lower in the treatment group. The incidence of postoperative nausea and vomiting (odds ratio = 0.5393 [0.1309; 2.2218], I = 60.4%) showed a trend towards reduction, although it was not statistically significant. While no adverse effects reaching statistical significance were reported in the analyzed studies, hematoma (proportional rate = 0.2133 [0.0905; 0.4250], I = 76.9%) and edema (proportional rate = 0.1935 [0.1048; 0.3296], I = 57.2%) after blocks appeared at rates of approximately 20%. : Infraorbital and/or infratrochlear nerve blocks for septorhinoplasty effectively reduce postoperative pain and emergence agitation without notable adverse outcomes.

摘要

通过对相关文献的全面荟萃分析,本研究评估了眶下和/或滑车神经阻滞在减少鼻中隔成形术后疼痛和相关并发症方面的效用和疗效。

我们检索了截至 2023 年 8 月的 PubMed、SCOPUS、Embase、Web of Science 和 Cochrane 数据库中的研究。分析纳入了 7 篇比较接受眶下和/或滑车神经阻滞的治疗组与接受安慰剂或无治疗的对照组的研究。评估的结果涵盖了术后疼痛、镇痛药使用的剂量和频率、术后恶心和呕吐的发生率以及出现激越的表现等参数。

治疗组的术后疼痛明显减轻(平均差异=-1.7236[-2.6825; -0.7646],I=98.8%),镇痛药使用的剂量(标准化均数差=-2.4629[-3.8042; -1.1216],I=93.0%)和频率(比值比=0.3584[0.1383; 0.9287],I=59.7%)也明显减少。与对照组相比,治疗组的出现激越(比值比=0.2040[0.0907; 0.4590],I=0.0%)发生率明显较低。术后恶心和呕吐(比值比=0.5393[0.1309; 2.2218],I=60.4%)的发生率虽有下降趋势,但无统计学意义。尽管在分析的研究中未报告达到统计学意义的不良反应,但阻滞后血肿(比例率=0.2133[0.0905; 0.4250],I=76.9%)和水肿(比例率=0.1935[0.1048; 0.3296],I=57.2%)的发生率约为 20%。

眶下和/或滑车神经阻滞用于鼻中隔成形术可有效减轻术后疼痛和出现激越,且无明显不良结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61be/10535682/448db88ab297/medicina-59-01659-g001.jpg

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