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用于射频鼻甲成形术的局部麻醉与黏膜下注射:疗效相同但无患者疼痛。一项比较研究。

Topical Anesthesia Versus Submucosal Injection for Radiofrequency Turbinoplasty: Same Benefit but without Patient's Pain. A Comparative Study.

作者信息

Giunta Antonio Alberto Maria, Cianchetta Filippo, Liberati Luca, De Luca Pietro, Ricci Giampietro, Di Stadio Arianna

机构信息

Otorhinolaryngology Department, Santa Maria Hospital of Terni, Terni, 05100 Italy.

Otorhinolaryngology Department, University of Perugia, Perugia, 06129 Italy.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3831-3839. doi: 10.1007/s12070-024-04716-6. Epub 2024 May 20.

Abstract

This study aimed at comparing the anesthetic efficacy of lidocaine injection versus pledgets soaked in lidocaine and epinephrine during radiosurgery of inferior turbinates. The study prospectively enrolled 120 outbound patients, who were randomly assigned to group 1 -anaesthesia with tampon soaked in lidocaine and adrenaline- or group 2 -anesthesia with tampon followed by lidocaine and adrenaline injection. The following parameters were evaluated by a visual analogue scale 1 h after surgery: pain, anxiety, chocking sensation and difficulty swallowing. Nasal obstruction, rhinorrhea, sneezing, headache and inferior turbinate size were evaluated preoperatively (T0), after 1 (T1), 2 (T2) and 3 months (T3) to surgery. The data collected were analyzed by statistic tests. Group 1 showed lesser pain than group 2 during the procedure ( < 0.01); no statistically significant differences were observed for anxiety, chocking sensation and difficulty swallowing. All patients, independently from the belonging group, significantly improved the nasal symptoms comparing T0 and T1 ( < 0.01), T2 ( < 0.01) and T3 ( < 0.01), without statistically significant differences among the groups. Radiofrequency turbinoplasty allowed to all patients to reduce the turbinates hypertrophy. Local anaesthesia with tampon allowed to obtain the same results the injective anaesthesia in term of surgical outcomes; the use of tampon allowed patients did not experience pain.

摘要

本研究旨在比较在下鼻甲放射外科手术中利多卡因注射与浸泡有利多卡因和肾上腺素的棉塞的麻醉效果。该研究前瞻性纳入了120例门诊患者,他们被随机分配到第1组——用浸泡有利多卡因和肾上腺素的棉塞进行麻醉——或第2组——先用棉塞麻醉,然后注射利多卡因和肾上腺素。术后1小时通过视觉模拟量表评估以下参数:疼痛、焦虑、哽咽感和吞咽困难。在术前(T0)、术后1个月(T1)、2个月(T2)和3个月(T3)评估鼻塞、鼻漏、打喷嚏、头痛和下鼻甲大小。收集的数据通过统计学检验进行分析。在手术过程中,第1组的疼痛程度低于第2组(<0.01);在焦虑、哽咽感和吞咽困难方面未观察到统计学上的显著差异。与T0相比,所有患者,无论所属组别,在T1(<0.01)、T2(<0.01)和T3(<0.01)时鼻症状均显著改善,组间无统计学显著差异。射频鼻甲成形术使所有患者的鼻甲肥大得以减轻。就手术效果而言,用棉塞进行局部麻醉与注射麻醉取得了相同的结果;使用棉塞使患者未经历疼痛。

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