Effects of Bupivacaine Versus Bupivacaine Plus Dexamethasone-Soaked Nasal Packing After Endoscopic Nasal Surgery

2019 ◽  
Vol 30 (4) ◽  
pp. 1174-1177 ◽  
Author(s):  
Ahmet Murat Yayik ◽  
Hasan Yildirim ◽  
Ali Ahiskalioglu ◽  
Muhammed Sedat Sakat ◽  
Özlem Dilara Ergüney ◽  
...  
2021 ◽  
pp. 014556132110331
Author(s):  
Yong Won Lee ◽  
Bum Sik Kim ◽  
Jihyun Chung

Objectives: Postoperative urinary retention (POUR) is influenced by many factors, and its reported incidence rate varies widely. This study aimed to investigate the occurrence and risk factors for urinary retention following general anesthesia for endoscopic nasal surgery in male patients aged >60 years. Methods: A retrospective review of medical records between January 2015 and December 2019 identified 253 patients for inclusion in our study. Age, body mass index (BMI), a history of diabetes/hypertension, American Society of Anesthesiologists (ASA) classification, and urologic history were included as patient-related factors. Urologic history was subdivided into 3 groups according to history of benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and current medication. The following was analyzed as perioperative variables for POUR development: duration of anesthesia and surgery; amount of fluid administered; rate of fluid administration; intraoperative requirement for fentanyl, ephedrine, and dexamethasone; postoperative pain; and analgesic use. Preoperatively measured prostate size and uroflowmetry parameters of patients on medication for symptoms were compared according to the incidence of urinary retention. Results: Thirty-seven (15.7%) patients developed POUR. Age (71.4 vs 69.6 years), BMI (23.9 vs 24.9 kg/m2), a history of diabetes/hypertension, ASA classification, and perioperative variables were not significantly different between patients with and without POUR. Only urologic history was identified as a factor affecting the occurrence of POUR ( P = .03). The incidence rate among patients without urologic issues was 5.9%, whereas that among patients with BPH/LUTS history was 19.8%. Among patients taking medication for symptoms, the maximal and average velocity of urine flow were significantly lower in patients with POUR. Conclusions: General anesthesia for endoscopic nasal surgery may be a potent trigger for urinary retention in male patients aged >60 years. The patient’s urological history and urinary conditions appear to affect the occurrence of POUR.


2021 ◽  
pp. 014556132110624
Author(s):  
Małgorzata Wierzchowska ◽  
Paulina Kalińczak-Górna ◽  
Błażej Grześkowiak ◽  
Kamil Radajewski ◽  
Jakub Burduk ◽  
...  

Background In addition to its hemostatic and stabilization role, biodegradable nasal packing can be used as a carrier for drugs after functional endoscopic sinus surgery (FESS). The aim of this study was to compare the influence of biodegradable synthetic polyurethane foam (NasoPore) soaked with ciprofloxacin, or betamethasone, or both to the same foam soaked with saline after FESS. Methods 120 adults with chronic rhinosinusitis, with and without polyps, directed for bilateral full-house FESS were enrolled for the study. The patients were randomized and blinded into 3 groups, depending on the type of postoperative procedure applied. Thus, NasoPore soaked with antibiotic was provided to the first group; in the second group, the steroid was used; and the combination of both, in the third group. In each case, the aforementioned procedure was administered on one side of the nose, while NasoPore was soaked in saline on the other, at the end of the surgery, respectively. The patients were requested to complete a questionnaire during their postoperative visits at 2, 10, 30, 90, and 180 days, scoring the level of complaints on the VAS scale, separately for each side. The evaluation of the healing process was performed at each visit using rigid endoscopy and subsequently rated on numerical scales. Results Decreased mucosal edema and secretion; reduced Lund-Kennedy score; and favorable influences on facial pressure, nasal blockage, and smell were most evidently seen in the group receiving the antibioticsteroid combination. Conclusions The application of biodegradable nasal packing with betamethasone and ciprofloxacin in sino-nasal surgery has positive effects not only on the healing process but also impacts patient’s comfort. To optimize it, however, further research is needed.


2008 ◽  
Vol 49 (3) ◽  
pp. 383 ◽  
Author(s):  
Yigal Leykin ◽  
Andrea Casati ◽  
Alessandro Rapotec ◽  
Massimiliano Dalsasso ◽  
Luigi Barzan ◽  
...  

2003 ◽  
Vol 17 (6) ◽  
pp. 327-333 ◽  
Author(s):  
Roland Giger ◽  
Basile Nicolas Landis ◽  
Chunquan Zheng ◽  
Didier-David Malis ◽  
Alma Ricchetti ◽  
...  

2020 ◽  
Author(s):  
Yong Won Lee ◽  
Bum Sik Kim ◽  
Jihyun Chung

Abstract Background: Postoperative urinary retention (POUR) after anesthesia and surgery is influenced by many factors, and its reported incidence rate varies widely. The aim of this study was to investigate the occurrence and risk factors for urinary retention following general anesthesia for endoscopic nasal surgery in male patients aged over 60 years. Methods: Retrospective review of medical records between January 2015 and December 2019 identified 253 subjects for inclusion in our study. Age, body mass index, history of diabetes/hypertension, American Society of Anesthesiologists classification, and urologic history were included as patient-related factors. Urologic history was subdivided into three groups according to history of benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and current medication. The following were analyzed as perioperative variables for the development of POUR: duration of anesthesia and surgery; amount of fluid administered; rate of fluid administration; intraoperative requirement for fentanyl, ephedrine, and dexamethasone; postoperative pain; and analgesic use. Preoperatively measured prostate size and uroflowmetry parameters of patients on medication for symptoms were compared according to the incidence of urinary retention.Results: Thirty-seven patients (15.7%) had urinary retention requiring catheterization. Among analyzed variables, only urologic history was identified as a predisposing factor. The incidence rate among patients without urologic issues was 5.9%. This compared to 19.8% among patients with a history of BPH/LUTS, which was not reduced by taking medical treatment. Among patients taking medication for symptoms, the maximal and average velocity of urine flow were significantly lower in subjects with POUR. Conclusions: General anesthesia for endoscopic nasal surgery is a potent trigger of urinary retention in male patients aged over 60 years. The urological history of the patient was the most important risk factor, and the occurrence of POUR appears to be affected by urinary conditions. The present study is helpful in understanding the occurrence of POUR following general anesthesia in elderly male patients.


Author(s):  
P P Naik ◽  
G Tsermoulas ◽  
A Paluzzi ◽  
L McClelland ◽  
S K Ahmed

Abstract Background The World Health Organization declared coronavirus disease 2019 a pandemic on 11th March 2020. There is concern regarding performing endonasal surgical procedures because of a high viral load in the nasopharynx. This paper describes our experience in conducting emergency and urgent endonasal operations during the peak of the coronavirus disease 2019 pandemic in the UK. Objectives To show the outcome of endonasal surgery during the peak of the coronavirus disease 2019 pandemic and to assess the post-operative rate of nosocomial coronavirus disease 2019 infection. Methods A retrospective cohort study was conducted of all patients who underwent high priority endoscopic nasal surgery or anterior skull base surgery between 23rd March and 15th June 2020 at University Hospitals Birmingham NHS Trust. Results Twenty-four patients underwent endonasal surgery during the study period, 12 were males and 12 were females. There was no coronavirus-related morbidity in any patient. Conclusion This observational study found that it is possible to safely undertake urgent endonasal surgery; the nosocomial risk of coronavirus disease 2019 can be mitigated with appropriate peri-operative precautions.


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