Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Oleshchenko, Irina G.; Çok, Oya Yalçın; Юрьева, Т. Н.; Заболотский, Д В; Kripak, Anna

doi:10.1136/rapm-2019-100823

Cited by 6 publications

(4 citation statements)

References 27 publications

(23 reference statements)

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“…Примечание: рисунок выполнен авторами. рургии пазух, а также в уменьшении боли, связанной с удалением тампонады носа после операций на носу за счет применения КНБ интраоперационно [25,26], КНБ применяется совместно с ОА с целью обезболивания в офтальмологии [4], стоматологии [14]. Как самостоятельный метод обезболивания блокаду крылонебного узла успешно применяют при множественных болевых синдромах, включая кластерные головные боли [27], невралгию тройничного нерва [28], мигрень [29], офтальмогерпес [30], постгерпетическую невралгию [31], атипичную лицевую боль и для лечения трудноизлечимых болей при раке головы и лица [32,33], а порой даже в тех случаях, когда объяснение его действия не всегда укладывается в привычные схемы, таких как боль на кончике пальца [34].…”

Section: обсуждение интерпретация результатовunclassified

“…Существуют разные доступы к крылонебному узлу: интраназальный [1], над-и подскуловой [2]. На сегодня крылонебная блокада (КНБ) часто используется как компонент анальгезии в лор-хирургии [3], а также в офтальмохирургии [4]. В данном обзоре сделан акцент на анальгетическом эффекте КНБ как самостоятельного метода обезболивания, вне зависимости от способа выполнения крылонебной блокады.…”

Section: Introductionunclassified

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The Analgetic Efficacy of Pterygopalatine Blockade for Pain Treatment in Adults: a Systematic Review and Meta-Analysis

Oleshchenko

Юрьева

Заболотский

2023

Kuban. nauсh. med. vestnik

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Background. The use of regional blockades for the purpose of analgesia is widely used in all fields of medicine, however, the analgesic efficacy of the pterygopalatine blockade, as an independent method of treating pain of various genesis, has not been studied enough. Therefore, there is a need to analyze the results of clinical trials to evaluate the analgesic efficacy of the pterygopalatine blockade as an independent method of anesthesia.Objective — to investigate the analgesic effect of pterygopalatine blockade as a monotherapy in patients with pain of various origins of oculotemporal area, conducting a meta-analysis of published results of randomized clinical trials.Methods. The methodology involved a systematic literature search by means of PubMed, MEDLINE, EMBASE, and Cochrane Library search engines. The search covered the period of the past 10 years and had the following criteria: a double-blind, randomized, controlled study of the use of pterygopalatine blockade with a local anesthetic versus placebo. For each included study, a standardized magnitude of the analgesic effect of pterygopalatine blockade compared to placebo was calculated, with pain assessing in 15, 30, and 60 minutes after the blockade was performed. Meta-analyses were conducted for each endpoint. Meta-analysis was performed using Stata 11.0 application programs ((The Cochrane Collaboration, Oxford, United Kingdom).Results. Five randomized controlled trials involving 269 patients met the inclusion criteria, and involved analyzing the pterygopalatine blockade with local anesthetic (n=140) against placebo (n=129). In 15 minutes after pterygopalatine blockade was performed, the difference in mean pain intensity compared to the control group was -2.5 points, the mean level was lower in the pterygopalatine blockade group, MD=-2.5 [95% CI -3.7; -1.7]. After 30 minutes: -2.7 points, MD=-2.7 [95% CI -4.5; -1.5], after 60 minutes: -1.7 points, MD=-1.7 [95% CI -4.0; -0.5]. The relative risk of adverse effects, such as nasopharyngeal symptoms, after performing a pterygopalatine blockade with a local anesthetic accounted for (RR =1.31 [95% CI 0.5–3.04]). In this regard, the incidence of complications and their variants that can be caused by pterygopalatine blockade is a matter for further clinical research.Conclusion. The results obtained in the meta-analysis testify to the analgesic effect of the pterygopalatine blockade as a monotherapy in patients with pain of different origins oculotemporal area in 15, 30, and 60 minutes after its performance. These data may be relevant when choosing a method for first-line anesthetic management of pain syndrome of oculotemporal area.

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Section: обсуждение интерпретация результатовunclassified

Section: Introductionunclassified

The Analgetic Efficacy of Pterygopalatine Blockade for Pain Treatment in Adults: a Systematic Review and Meta-Analysis

Oleshchenko

Юрьева

Заболотский

2023

Kuban. nauсh. med. vestnik

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“…Sex, n (%) All patients underwent plastic surgery of the inferior orbital rim wall. 30 minutes before surgery, all patients underwent utrasoundguidedpterygopalatine blockade through an infrazygomatic access by the impegnation technique we presented before [6]. The patient was placed in a supine position, the head was turned to the contralateral side and after sterilization of the block side of the face, the mouth was slightly opened to ease the ultrasound navigation with a high-frequency linear probe (Sonosite EdgeII; Fujifilm Sono Site, Bothwell, Washington, USA) to visualize the pterygopalatine fissure.…”

Section: Group N =mentioning

confidence: 99%

“…Regional anesthesia is widely and often used in various fields of medicine, allowing both reducing intraoperative opioid loading and improving the rehabilitation period by creating an anti-inflammatory effect [5,6]. The inability to perform an infraorbital blockade to anesthetize during surgery of the inferior orbital rim wall is associated with the displacements of bone fragments in the infraorbital foramen after the fracture [7].…”

Section: Introductionmentioning

confidence: 99%

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

OP¹,

AV²,

DV³

2022

Act Scie Ortho

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The analgesic effect of the pterygopalatine blockade is successfully used as anesthesia in otolaryngology, with volumetric surgical interventions in the maxillofacial region and as an interventional method for the treatment of migraine, cluster and chronic facial pain, in the treatment of post-functional pain syndrome, postherpetic neuralgia.The purpose of this study is to evaluate the analgesic effect of the infra zygomatic access of performing a pterygopalatine block as a component of combined anesthesia during reconstructive surgery for fractures of the lower orbital edge. Research and Design:The study was carried out at Irkutsk Branch of S. Fyodorov "Eye microsurgery" Federal State Institution of Ministry of Health of the Russian Federation. 9 male patients with the fractures of the lower orbital edge were included.Material and Methods: Pterygopalatine blockade as a component of combined anesthesia was performed through a infrazygomatic access by the impegnation technique for pain management in reconstruction of the inferior orbital rim wall. A 25 mm needle with a 23G diameter was used to anesthetize the pterygopalatine ganglion and the maxillary nerve with solutions of local anesthetics (lidocaine 2% -2 ml and ropivacaine 0.75% -2 ml). The following parameters were evaluated: the adequacy of anesthesia, the duration of the analgesic effect of the pterygopalatine blockade by Verbal Rating Scale, the appointment of additional anesthesia, patient comfort, complications after the blockade.Results: Pterygopalatine blockade as component of a combined anesthesia was effective intraoperatively and didn't cause hemodynamic changes during surgery. During a postoperative period, patients felt comfortable without pain. No additional anesthesia required. The length of the block varied from 4 to 6 hours. Such complications as hemorrhages, intravascular injection of anesthetic, trauma of neural structures were not noticed. Conclusion:Pterygopalatine block is a good alternative to both intra and post operative anesthesia in reposition of the inferior orbital rim wall.

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Postoperative anesthesia for vitreoretinal surgery in children

Oleshchenko

Заболотский

Юрьева

et al. 2021

Regional Anesthesia and Acute Pain Management

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Vitreoretinal surgery for retinal detachments in children is an effective, sometimes the only method to restore vision. As practice shows, the use of minimally invasive regional techniques is increasingly used for combined anesthesia in ophthalmic surgery in children. In the postoperative period, the use of blockades can provide prolonged analgesia, thereby improving the childs comfort level after the surgery. All types of blockades in ophthalmology have certain risks, but the pterygopalatine blockade has not any, since it is performed outside the eye structures. The research of the use of the pterygopalatine blockade after surgery in children is important not only for creating prolonged analgesia, but also for reducing vegetative reactions that can complicate the recovery period. Purposeof the study isto increase the pain management efficacy in the postoperative period in children who have undergone extensive surgery for retinal detachment. Materials and methods. 1st group (n= 32) received postoperative analgesia pterygopalatine blockage with ropivacaine 0.5%, 2nd group (n= 28) systemic analgesia. Changes in hemodynamics and stress index in the postoperative period were evaluated. Cortisol levels in the intensive care unit was evaluated in 2 hours later. The time and frequency use of antiemetics in the occurrence of PONV were recorded. The level of patients comfort after surgery and the pain intensity were evaluated on an integral scale and on the Verbal Rating Scale (VRS) in points. Results.The children of 1st group did not have significant changes in heart rate and SBP in the intensive care unit. In group 1, the TI decreased by 13.2% in the intensive care unit, and in group 2, the TI increased by 28.5% after 2 hours and by 88.6% after 8 hours. 2 hours after the surgery pain was 2 points in 12.5% of the patients (1st group) and 39.2% of patients (2nd group). After 8 hours, 35.7% of patients (2nd group) reported moderate pain that required medication. There were no PONV in group 1, and it occured in 28.5% of patients in group 2. In group 1, 75% of children rated the postoperative period as comfortable, and in group 2 21.4% (p 0,05). Conclusion. Pterygopalatine blockade as the main method of postoperative analgesia in the early postoperative period has got a long-term analgesic effect, reducing the frequency of nausea and vomiting, improving the quality of the postoperative period in children.

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Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Cited by 6 publications

References 27 publications

The Analgetic Efficacy of Pterygopalatine Blockade for Pain Treatment in Adults: a Systematic Review and Meta-Analysis

The Analgetic Efficacy of Pterygopalatine Blockade for Pain Treatment in Adults: a Systematic Review and Meta-Analysis

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

Postoperative anesthesia for vitreoretinal surgery in children

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