Role of local anaesthetic nerve block in patients undergoing endonasal surgery – our experience of 48 patients

• Main Authors: Eamon Shamil, Elizabeth Casselden, Florian Bast, Will Whiteley, Claire Hopkins, Pavol Surda
• Format: Article
• Language: English
• Published: Stichting NASE 2018-08-01
• Series: Rhinology Online
• Subjects: pterygopalatine ganglion block; nerve block; postoperative pain
• Online Access: https://www.rhinologyonline.org/Rhinology_online_issues/manuscript_24.pdf

Objective: This study examines the effect of preoperative AEN block and SPG nerve block with 0.5 % bupivacaine and 1:200,000 adrenaline (LA) on postoperative pain in patients undergoing endonasal surgery. Study design: This is non-randomised and partly blinded study of 48 patients undergoing ESS. 30 patients underwent pre-operative SPG and AEN local anaesthetic blockade and remaining 18 patients served as controls. Results: The pain score at 1, 2 and 3 hours after the surgery in local anaesthetic vs. control group was 1.1 vs. 2.8 (p<0.001), 1.4 vs 3.4 (p<0.001) and 1.7 vs 3.5 (p<0.001), respectively. The most significant difference of 1.94 points (p<0.001) on the VAS scale was seen at 2 hours. No complications were observed in either group. Conclusion: Our results have indicated that there is a significant reduction in the first three hours of post-operative pain after endonasal surgery in patients who underwent blockage of these nerves, compared to a control group. However, this study was neither randomised nor blinded and sample size was small. Further study in the form of larger randomised trial is therefore needed.