Comparison of local anaesthesia with dexmedetomidine sedation and general anaesthesia during septoplasty

Doğan, Rafi; Erbek, Selim S.; Gonencer, Huseyin H; Erbek, Harun; Işbilen, Cengiz; Arslan, G.

doi:10.1097/eja.0b013e32833a45c4

Cited by 46 publications

(51 citation statements)

References 17 publications

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“…In addition, in other studies, the pain score of patients was significantly lower when dexmedetomidine was used compared to the general anesthesia group or the group with no anesthesia, and this confirms that dexmedetomidine has an analgesic effect [8,10]. In our study, the pain score of the MAC group measured in the recovery room was 28.84 mm Fig.…”

Section: Discussionsupporting

confidence: 66%

“…Precedent studies generally defined pain as being properly managed when the pain score is 30 mm or lower [7,8,10], and in our study, the mean pain score of both groups was well inside this range. We believe this is because the closed reduction of the nasal bone performed in this study is a relatively non-invasive procedure, and the pain from the operation is not great.…”

Section: Korean J Anesthesiolmentioning

confidence: 65%

“…In previous studies which performed sedation with dexmedetomidine, the sedative effect necessary for procedure was main tained while there was no occurrence of respiratory inhibition such as reduced oxygen saturation, increased end-tidal CO 2 , or decrease in respiration rate to the end of the procedure [7][8][9]. In this study also, when the sedated state of BIS 60-80 was induced during the operation with dexmedetomidine, there was no occurrence of cases in which SaO 2 decreased to 90% or lower.…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine can control the degree of sedation according to the dosage while minimizing respiratory inhibition, and also has an analgesic effect by suppressing the sympathetic nerve system; therefore, it has recently been used as anesthesia or an anesthesia supplement in various procedures [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Reasons for this are from differences in the operating surgeon, and in the type and method of the surgery. Dogan et al [8] reported that the satisfaction of patients was higher in local anesthesia using dexmedetomidine compared to general anesthesia. In our research, there was no difference between groups in satisfaction scores, and the patients were generally satisfied.…”

Section: Korean J Anesthesiolmentioning

confidence: 99%

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General anesthesia versus monitored anesthetic care with dexmedetomidine for closed reduction of nasal bone fracture

Lee

Kim

et al. 2013

European Journal of Anaesthesiology

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Background: Reduction of nasal bone fracture can be performed under general or local anesthesia. The aim of this study was to compare general anesthesia (GA) and monitored anesthetic care (MAC) with dexmedetomidine based on intraoperative vital signs, comfort of patients, surgeons and nurses and the adverse effects after closed reduction of nasal bone fractures. Methods: Sixty patients with American Society of Anesthesiologists physical status I or II were divided into a GA group (n = 30) or MAC group (n = 30). Standard monitorings were applied. In the GA group, general anesthesia was carried out with propofol-sevoflurane-N 2 O. In the MAC group, dexmedetomidine and local anesthetics were administered for sedation and analgesia. Intraoperative vital signs, postoperative pain scores by visual analog scale and postoperative nausea and vomiting (PONV) were compared between the groups. Results: Intraoperatively, systolic blood pressures were significantly higher, and heart rates were lower in the MAC group compared to the GA group. There were no differences between the groups in the patient, nurse and surgeon's satisfaction, postoperative pain scores and incidence of PONV. Conclusions: MAC with dexmedetomidine resulted in comparable satisfaction in the patients, nurses and surgeons compared to general anesthesia. The incidence of postoperative adverse effects and severity of postoperative pain were also similar between the two groups. Therefore, both anesthetic techniques can be used during the reduction of nasal bone fractures based on a patient's preference and medical condition. (Korean J Anesthesiol 2013; 65: 209-214)

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Section: Discussionsupporting

confidence: 66%

Section: Korean J Anesthesiolmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Korean J Anesthesiolmentioning

confidence: 99%

See 3 more Smart Citations

General anesthesia versus monitored anesthetic care with dexmedetomidine for closed reduction of nasal bone fracture

Lee

Kim

et al. 2013

European Journal of Anaesthesiology

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Efficacy of dexmedetomidine on perioperative morbidity during nasal surgery: A meta‐analysis

et al. 2017

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Perioperative Analgesia for Patients Undergoing Septoplasty and Rhinoplasty: An Evidence‐Based Review

et al. 2018

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Objectives/Hypothesis Opioid misuse and diversion is a pressing topic in today's healthcare environment. The objective of this study was to conduct a review of non‐opioid perioperative analgesic regimens following septoplasty, rhinoplasty, and septorhinoplasty. Study Design Evidence‐based systematic review. Methods PubMed, MEDLINE, Cochrane Library, and Embase databases were reviewed for articles related to perioperative analgesic use in septoplasty, rhinoplasty, and septorhinoplasty. Quality of studies were assessed via the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria, Jadad scores, and the Cochrane bias tool. Patient demographic data and clinical outcomes, including medication type, dose, administration time, pain scores, and adverse events, were obtained from included studies. Summary tables detailing the benefits and harms of each investigated regimen are included. Results Thirty‐seven studies met inclusion criteria for this evidence‐based review. The quality of the studies was determined to be of moderate quality based off of GRADE standardized criteria with a mean Jadad score of 3.1. A preponderance of evidence showed reduced perioperative pain scores and rescue analgesic requirements, supporting the use of local anesthetics for analgesic control. Nonsteroidal anti‐inflammatory drugs (NSAIDs) demonstrated similar decreased visual analog scores and postoperative analgesic demand; however, increased adverse events in this class warrant caution. Conclusions Contemporary literature supports the use of NSAIDs, gabapentin, local anesthetics, and α‐agonists as effective perioperative analgesic opioid alternatives for septoplasty and septorhinoplasty. Local anesthetic use is a cost‐effective option resulting in decreased postoperative pain scores and rescue analgesic requirements. Further large‐scale, multi‐institutional, controlled studies are needed to provide definitive recommendations. Level of Evidence NA Laryngoscope, 129:E200–E212, 2019

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Comparison of local anaesthesia with dexmedetomidine sedation and general anaesthesia during septoplasty

Abstract: Septoplasty performed under local anaesthesia with dexmedetomidine sedation resulted in less surgical bleeding, less postoperative pain, a more stable haemodynamic state, less nausea-vomiting, a shorter recovery period and a higher level of anaesthesia satisfaction.

Cited by 46 publications

References 17 publications

General anesthesia versus monitored anesthetic care with dexmedetomidine for closed reduction of nasal bone fracture

General anesthesia versus monitored anesthetic care with dexmedetomidine for closed reduction of nasal bone fracture

Efficacy of dexmedetomidine on perioperative morbidity during nasal surgery: A meta‐analysis

Perioperative Analgesia for Patients Undergoing Septoplasty and Rhinoplasty: An Evidence‐Based Review

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