Analgesia after otoplasty: regional nerve blockade vs local anaesthetic infiltration of the ear

Cregg, Nuala; Conway, Frances; Casey, William

doi:10.1007/bf03011255

Cited by 40 publications

(20 citation statements)

References 15 publications

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“…In children, the axillary block is one of the most popular approaches to the brachial plexus (Cregg et al, 1996). Due to the abundance of vessels in the axillary region, caution must be taken when performing this block to avoid intravascular injection.…”

Section: Outcome and Discussionmentioning

confidence: 99%

Ultrasound Imaging for Pediatric Anesthesia: A Review

Suresh¹,

Taylor²,

Minhas³

2011

Ultrasound Imaging

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Section: Outcome and Discussionmentioning

confidence: 99%

Ultrasound Imaging for Pediatric Anesthesia: A Review

Suresh¹,

Taylor²,

Minhas³

2011

Ultrasound Imaging

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“…The conventional approach for great auricular nerve blockade is a landmark-based technique, where the injection point is determined by drawing lines between the superior margin of the cricoid cartilage and the posterior border of the sternocleidomastoid muscle, with local anaesthetic subcutaneously injected at the intersection [5,8,9]. Interestingly, most descriptions of great auricular nerve blockade are in Table 1 Analysis of blocked areas (indicated by 'X') in each individual volunteer.…”

Section: Discussionmentioning

confidence: 99%

“…Seven different sensory distribution patterns have been observed 10 min after blockade of the great auricular nerve. children [5,[7][8][9]15], whereas only a few cases are reported in adults [14]. Ultrasound guidance enables selective blockade of small nerve structures with minimal volumes of local anaesthetic.…”

Section: Discussionmentioning

confidence: 99%

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Great auricular nerve blockade using high resolution ultrasound: a volunteer study

et al. 2010

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SummaryThis prospective, observational volunteer study aimed to describe the appearance of the great auricular nerve using ultrasound and its blockade under ultrasound guidance. An in‐plane needle guidance technique was used for blockade of the great auricular nerve with 0.1 ml mepivacaine 1%. Sensory block was evaluated by pinprick testing in comparison with the contralateral area propriae. The great auricular nerve was successfully seen in all volunteers and the tail of the helix, antitragus, lobula and mandibular angle were blocked in all cases whereas the antihelix and concha were never blocked. Ultrasound imaging of the great auricular nerve can be reliably achieved and successful blockade with minimal volumes of local anaesthetic is another example of the benefits of ultrasound‐guided peripheral nerve blocks.

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“…[1][2][3] Bilateral superficial cervical plexus block may also reduce postoperative analgesic requirements in children undergoing ear surgery. 4,5 A review of our experience with cochlear implantation identified a greater postoperative opioid consumption in children undergoing bilateral simultaneous cochlear implantation (BSiCI) when compared with children undergoing unilateral implants, and a suspicion arose that the greater analgesic requirement was a reflection of increased postoperative pain. 6 In an effort to decrease the discomfort related to the implant site and possibly decrease postoperative opioid requirements, intraoperative BSCPB was recently adopted and applied to all our children undergoing general anesthesia for BSiCI.…”

Section: Résumémentioning

confidence: 99%

Unexplained fever after bilateral superficial cervical block in children undergoing cochlear implantation: an observational study

Merdad

Crawford

Gordon

et al. 2011

Can J Anesth/J Can Anesth

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Purpose In an effort to decrease postoperative opioid requirements, intraoperative bilateral superficial cervical plexus block (BSCPB) was recently adopted for all our children undergoing general anesthesia for bilateral simultaneous cochlear implantation (BSiCI). Several cases of early postoperative fever were noted after the adoption of BSCPB. Our aim was to determine if an association exists between BSCPB and early postoperative fever in children undergoing BSiCI. As a secondary outcome, we studied the efficacy of BSCPB in altering postoperative analgesic requirements. Methods We conducted a retrospective cohort study of 91 consecutive children who underwent BSiCI. The series included 34 patients who received BSCPB (Block Group) and 57 patients who did not receive BSCPB (No-block Group). Results The median age (range) was 15.4 months (eight months -15 yr). A significant association was found between BSCPB and postoperative fever (P = 0.006). Eighteen (19.7%) children developed fever in the first 24 hr after surgery (Block Group: 12/34 [35%]; No-block Group: 6/57 [11%]; P = 0.006). The Block Group was 4.8 times more likely to develop early postoperative fever after adjusting for other variables (P = 0.004). The Block Group spent more days in hospital after surgery compared with the No-block Group (P = 0.043). Other vital signs showed no major deviation from the normal ranges, and daily physical examinations revealed no obvious source of infection in children who developed postoperative fever. Conclusion Bilateral superficial cervical plexus block may increase the risk of postoperative fever in children undergoing BSiCI. In this series, BSCPB was associated with a longer hospital admission. The etiology of the fever is undetermined, although it can be hypothesized that BSCPB resulted in unintended block of the phrenic nerves leading to diaphragmatic paralysis, atelectasis, and early postoperative fever in young children. RésuméObjectif Dans un effort visant a`diminuer les besoins postope´ratoires en morphiniques, le bloc bilate´ral perope´ratoire du plexus cervical superficiel (BSCPB) a e´teŕ e´cemment adopte´pour tous les enfants ayant une anesthe´sie ge´ne´rale pour implantation cochle´aire bilate´rale simultane´e (BSiCI). Plusieurs cas de fie`vre postope´ratoire pre´coce ont e´teć onstate´s apre`s l'adoption du BSCPB. Notre but e´tait de de´terminer s'il existe une association entre le BSCPB et la fie`vre postope´ratoire pre´coce chez des enfants subissant une BSiCI. Nous avons e´galement e´tudie´comme crite`re d'e´valuation secondaire l'efficacite´du BSCPB a`modifier les besoins en analge´siques postope´ratoires. Méthodes Nous avons mene´une e´tude de cohorte re´trospective sur 91 enfants conse´cutifs subissant une BSiCI. La se´rie a inclus 34 patients qui avaient eu un

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Analgesia after otoplasty: regional nerve blockade vs local anaesthetic infiltration of the ear

Cited by 40 publications

References 15 publications

Ultrasound Imaging for Pediatric Anesthesia: A Review

Ultrasound Imaging for Pediatric Anesthesia: A Review

Great auricular nerve blockade using high resolution ultrasound: a volunteer study

Unexplained fever after bilateral superficial cervical block in children undergoing cochlear implantation: an observational study

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