Molliex S, Navez M, Baylot D, Prades J M, Elkhoury Z, Auboyer C
Département d'Anesthésie et de Réanimation Chirurgicale, St-Etienne, France.
Br J Anaesth. 1996 Jan;76(1):151-3. doi: 10.1093/bja/76.1.151.
Regional anaesthesia is not used widely for outpatient nasal surgery. The aim of this study was to determine the role of nasociliary and infraorbital nerve block in 24 patients undergoing nasal surgery comprising: cosmetic or reconstructive surgery of the nose and surrounding soft tissue, polypal removal, turbinectomy, reduction of fractured nasal bones, small tumour resection or emergency surgery on isolated facial lacerations. Mild sedation with midazolam 0.03 mg kg-1 was used before anaesthesia. Nasociliary and infraorbital blocks were technically easy to perform, safe and provided good intraoperative conditions. Only minor complications were observed, including local bruising in eight patients and transient diplopia in one patient. No patient received general anaesthesia, but infiltration of local anaesthetic was necessary in four patients because of incomplete anaesthesia in the surgical area. Operative conditions were judged as good or excellent by surgeons in 20 of 24 patients. Twenty of 24 patients were very satisfied or satisfied with anaesthesia. Duration of surgery exceeding 60 min and excessive bleeding in the nasopharynx were the main limiting factors for the use of facial regional anaesthesia.
区域麻醉在门诊鼻部手术中并未广泛应用。本研究的目的是确定鼻睫状神经阻滞和眶下神经阻滞在24例接受鼻部手术患者中的作用，这些手术包括：鼻及周围软组织的美容或重建手术、息肉切除、鼻甲切除术、鼻骨骨折复位、小肿瘤切除或孤立面部裂伤的急诊手术。麻醉前使用0.03 mg/kg的咪达唑仑进行轻度镇静。鼻睫状神经阻滞和眶下神经阻滞在技术上易于实施、安全且能提供良好的术中条件。仅观察到轻微并发症，包括8例患者局部瘀斑和1例患者短暂性复视。没有患者接受全身麻醉，但由于手术区域麻醉不完全，4例患者需要局部麻醉药浸润。24例患者中有20例患者的手术条件被外科医生判定为良好或优秀。24例患者中有20例对麻醉非常满意或满意。手术时间超过60分钟和鼻咽部出血过多是面部区域麻醉使用的主要限制因素。
