xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

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There was a trend toward reduced postoperative pain with bupivacaine compared to saline after ESS.

Infraorbital nerve block with general anesthesia is effective in reducing the consumption of isoflurane and

postoperative pain intensity in ESS. Long acting anesthetic agent bupivacaine provided similar analgesia to shorter acting anesthetic agent lidocaine.

SPG block with bupivacaine was a simple, safe, and effective method to manage post-operative pain afer ESS.

Use of levobupivavaine packs after ESS is an effective method to control postoperative pain and improves patient

comfort/tolerability compared to saline control.

Bupivacaine nasal packs resulted in lower pain values, less additional analgesia, and less nasal discharge and bleeding after ESS.

SPG block with bupivacaine or levobupivacaine improved postoperative

analgesia compared to saline control with good patient and surgeon satisfaction.

Bilateral infraorbital bupivacaine does not decrease actual time to discharge after outpatient nasal surgery despite a

beneficial effect on postoperative pain following GA in ESS patients.

Study Year LOE Design Study Groups Clinical Endpoint Conclusions Kesimci 1889 2012 2 Prospective, DB RCT

Postoperative VAS POD 0, 7, 30. SNOT-20

Postoperative pain intensity at 15minutes

VAS at immediately post-op, 6, 12, 24, 48 hours and 7 and 21 days after surgery

minutes and 1, 2, 8, 12, 24 hours

Postoperative VAS at 1, 2, 4, 8, 12, and 24 hours Requirement for rescue analgesia

Postoperative VAS at 2, 6, and 24 hours after surgery

Duration of post anesthesia recovery Pain scores

Postoperative NRS at 2, 6, and 24hours Analgesic requirement

CT/ Endoscopy scores

Isoflurane consumption

Postoperative VAS at 30

Rescue analgesia consumption

Presence of synechia

Additional analgesics required

Levobupivavaine hydrochloride sinus pack (20) Saline sinus pack (21)

Bupivacaine injection (29) Saline injection (27)

Bupivacaine injection (15) Saline injection (25)

Bupivacaine sinus pack (30)

Ropivacaine sinus pack (30) Prilocaine sinus pack (30) Saline sinus pack (30)

Saline injection (20)

Bupivacaine injection (15)

Levobupivacaine injection (15) Saline injection (15)

Bupivacaine injection (20) Saline injection (20)

Lidocaine injection (39)

Bupivacaine injection (44)

Rezaeian 1894 2019 3 c Prospective, RCT Bupivacaine injection (20) Yilmaz 1872 2013 3 d Prospective, DB RCT

Cho 1890 2011 2 Prospective, DB RCT

Higasahawa 1892 2001 2 Prospective, DB RCT

Triple-Blinded RCT

Friedman 1893 1996 2 Prospective, DB RCT

Mariano 1891 2009 2 Prospective,

Haytoglu 1895 2016 3 b Prospective, RCT Lidocaine sinus pack (30)

TABLE XII-4 (Continued)