xRead - Nasal Obstruction (September 2024) Full Articles

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Orlandi et al.

(Continues)

The introduction of NSAIDs to acetaminophen and opioid pain regimen results in reduced pain and overall opioid use.

SPG injection of 2% lidocaine with epinephrine effectively reduces pain and need for analgesia after ESS.

Lidocaine-soaked packs significantly reduced postoperative pain without significant changes to vital signs.

A single IV dose of ketoprofen during anesthesia is an effective alternative to

pethidine and provides lower pain scores and faster recovery.

Bilateral infraorbital nerve block with 0.25% levobupivacaine is an effective technique in the treatment of postoperative pain in nasal surgery and can be used safely with adjuncts.

Regional anesthesia using SPG blockade appears to shorten hospital stay and reduce narcotic requirements

immediately post-operatively, but loses these effects after 24 hour in ESS patients.

Study Year LOE Design Study Groups Clinical Endpoint Conclusions Elhakim 1886 1991 2 Prospective, DB RCT

immediately after surgery,

6, and 24 hours after surgery

Postoperative VAS at 1, 4, 8, 16, 20, and 24 hours after surgery Blood soaked guaze Vital signs Recovery time

Postoperative VAS at 1, 2, and 4hours Opioid consumption Adverse events

Postoperative NRS at 1, 2, 4, 6, and 12 hours

Postoperative NRS every 15 minutes until discharge Adverse events

Postoperative VAS scores Mean opioid pills taken Bleeding rate

Postoperative VAS

Time to first analgesic dose

Total meperidine requirement

Opioid consumption

Levobupivicaine injection (15) Levobupivicaine + tramadol injection (15) Saline injection (15)

NSAID group – ibuprofen 200 mg, acetaminophen 325 mg,

hydrocodone- acetaminophen 5/325 mg rescue PO (101) Non-NSAID group -

acetaminophen 325 mg,

hydrocodone- acetaminophen 5/325 mg PO (65) Saline injection (30)

Lidocaine-soaked polyurethane foam pack (31)

Saline-soaked polyurethane foam pack (32) Lidocaine injection (35) Saline injection (35)

Lidocaine injection (30)

Ketoprophen IV (30) Pethidine IV (30)

Wu 1871 2019 3 Prospective cohort study

Al-Qudah 1873 2013 2 Prospective, DB RCT

Mo 1887 2013 2 Prospective, DB RCT

Cekic 1874 2013 2 Prospective, DB RCT

DeMaria 1888 2012 2 Prospective, DB RCT

TABLE XII-4 (Continued)

Local Anesthetic