Local anesthesia with sedation versus local anesthesia after general anesthesia for sinus surgery: a randomized trial

2017 ◽  
Vol 4 (4) ◽  
pp. 188
Author(s):  
MohamedT Ghanem ◽  
Ashraf Elmalt
Keyword(s):  
General Anesthesia ◽  
Randomized Trial ◽  
Local Anesthesia ◽  
Sinus Surgery

scholarly journals Comparison of Labetalol, Nitroglycerine and High Dose Propofol for Induced Hypotension in Functional Endoscopic Sinus Surgery in Massive Nasal Polyposis: A Randomized Trial

2020 ◽  
Author(s):  
Seyed Mohammad Mireskandari ◽  
Jalil Makarem ◽  
Babak Saedi ◽  
Afshin Jafarzadeh ◽  
Kasra Karvandian ◽  
...  
Keyword(s):  
Blood Loss ◽  
General Anesthesia ◽  
Randomized Trial ◽  
Sinus Surgery ◽  
P Value ◽  
High Dose ◽  
Induced Hypotension ◽  
Duration Of Surgery ◽  
Field Quality ◽  
Surgical Field

Background: Objective: The aim of this study was to assess the quality of the surgical field, amount of blood loss, and duration of surgery following induced hypotension with labetalol, nitroglycerin, and high dose propofol in patients undergoing FESS under general anesthesia. Methods: One hundred and eight patients scheduled for FESS under general anesthesia were recruited in this randomized trial and were allocated to one of the three study groups: 1) Nitroglycerine (NTG) group: nitroglycerine with a dose of 2-5 μg/kg/min was administered; 2) Labetalol (LAB) group: an IV bolus dose of labetalol (20 mg) was injected at first and then IV infusion of labetalol at a rate of 1-2 mg/min; 3) High dose propofol plus normal saline (0.5-1 ml/min) group. Hemodynamic variables and the amount of bleeding were recorded intraoperatively and the surgeons' satisfaction was asked following each surgery considering the surgical field quality using a 5-item Likert scale. Results: The average blood loss (ml) in patients in the LAB group was significantly less than patients in NTG and high dose propofol groups (127 ml vs 198 and 145 ml, respectively) (p- value=0.001) and the surgeons expressed greater satisfaction with the surgical field quality in the LAB group (p- value=0.001). Conclusion: Labetalol infusion may be a safe and effective method for induction of controlled hypotension to provide a comparatively bloodless field. High dose propofol may be a second choice if labetalol is not available.

scholarly journals Pilonidal Sinus Operations Performed Under Local Anesthesia versus the General Anesthesia: Clinical Trial Study

2016 ◽  
Vol 8 (9) ◽  
pp. 200 ◽  
Author(s):  
Nasrin Rahmani ◽  
Afshin Gholipour Baradari ◽  
Seyed Mohammad-Javad Heydari Yazdi ◽  
Abolfazl Firouzian ◽  
Seyyed Abbas Hashemi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Pilonidal Sinus ◽  
Recovery Time ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
The Mean

<p><strong>BACKGROUNDS:</strong> Various methods were defined to prepare patients for the pilonidal sinus surgery including local, spinal, and general anesthesia. But there is no powerful evidence to differ these procedures. Therefore, in the current study, we compared local and general anesthesia in the pilonidal sinus surgery.</p><p><strong>METHODS &amp; MATERIAL:</strong> in this clinical trial (IRCT201312031786N5) study 60 patients with the pilonidal sinus disease divided to two groups of local anesthesia versus general anesthesia. For local anesthesia we used 6ml of 2% lidocaine with an epinephrine (1:200,000), 6ml of 0.5% bupivacaine, 1ml fentanyl (50μg/ml), 1ml clonidine (75μg/ml) and for general anesthesia fentanyl 1.5 μg.kg-1, thiopental 3-5 mg.kg-1, followed by the trachea intubation facilitated by atracurim 0.5 mg.kg-1 with maintenance of isoflurane 1-3% in nitrous oxygen 70% and oxygen 30%. The student t-test and Chi-square test were applied to evaluate the differences.</p><p><strong>RESULTS:</strong> there were 30 patients with the mean age of 27.43±8.42 years in local anesthesia group and 30 cases with the mean age of 27.5±8.44 years underwent general anesthesia. The recovery time was significantly lower in the local anesthesia group (P=0.000). The oxygen saturation of the general anesthesia group was significantly higher at 1 and 20 minutes after the operation. The average of pain score was significantly higher in general anesthesia group at 3h and 6h after surgery (P&lt;0.001). There were no significant differences in post-operative complications and hospital length of stay.</p><p><strong>CONCLUSION: </strong>this investigation revealed that local anesthesia has decreased pain during 48 hours after the surgery, shorter recovery time, and the less consumption of painkillers. So, we concluded that we can consider local anesthesia as a good alternative for the general anesthesia in the pilonidal sinus surgery.</p>

Operative times, postanesthesia recovery times, and complications during sinonasal surgery using general anesthesia and local anesthesia with sedation

2000 ◽  
Vol 122 (4) ◽  
pp. 560-566 ◽  
Author(s):  
Fred G. Fedok ◽  
Richard E. Ferraro ◽  
Charles P. Kingsley ◽  
John A. Fornadley
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Outpatient Surgery ◽  
Perioperative Complications ◽  
Retrospective Chart Review ◽  
Sinus Surgery ◽  
Complication Rates ◽  
Recovery Times ◽  
Unplanned Admissions

OBJECTIVE The goal was to compare complication rates and recovery times in patients undergoing elective septoplasty or endoscopic sinus surgery using local anesthesia with sedation (LAS) versus general anesthesia (GA). METHODS AND PATIENTS A retrospective chart review of a consecutive sample of 177 patients undergoing elective septoplasty or endoscopic sinus surgery between July 1, 1994, and June 30, 1996, was carried out at our university-based outpatient surgery unit. Outcome measures included total operative time, surgical time, recovery time, and perioperative complications. RESULTS Total operative and recovery times were shorter in patients undergoing LAS. The frequency of emesis, epistaxis, and nausea were less in the LAS population than in the GA population. Three patients who underwent GA required unplanned admissions. CONCLUSION This study suggests that in selected patients undergoing sinonasal surgery, LAS may result in shorter total operative times, shorter recovery times, and less frequent nausea, emesis, and epistaxis than GA.

Comparison of Functional Endoscopic Sinus Surgery under Local and General Anesthesia

1993 ◽  
Vol 102 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Paul D. Gittelman ◽  
Joseph B. Jacobs ◽  
Jane Skorina
Keyword(s):  
Blood Loss ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Intravenous Sedation ◽  
New York University ◽  
Major Complications ◽  
Estimated Blood Loss

We present a retrospective comparison of intravenous sedation and general anesthesia techniques employed at New York University—Bellevue Medical Center for functional endoscopic sinus surgery. Some authors have stressed the use of local anesthesia with intravenous sedation in order to avoid complications and reduce blood loss. We have reviewed 232 patients who underwent 401 consecutive ethmoidectomies and maxillary antrostomies. Local anesthesia, employed in 64% of patients, carried an estimated blood loss of 23 mL per side. General anesthesia was associated with an average blood loss of 58 mL per side. The rate of operative complications for local anesthesia was 8.7% per patient, with a 1.6% rate of major complications per side. General anesthesia carried an overall complication rate of 2.4% per patient, with no major complications. General anesthesia is a relatively safe and viable option for endoscopic sinus surgery that in selected cases may be preferable to local anesthesia.

Forced coughing versus local anesthesia and pain associated with cervical biopsy: A randomized trial

2008 ◽  
Vol 68 (04) ◽  
Author(s):  
BC Schmid ◽  
S Pils ◽  
G Heinze ◽  
L Hefler ◽  
A Reinthaller ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Local Anesthesia ◽  
Cervical Biopsy

scholarly journals Junctional Rhythm Preoperatively and During General Anesthesia for Oral and Maxillofacial Surgery

2017 ◽  
Vol 64 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Naotaka Kishimoto ◽  
Ikue Kinoshita ◽  
Yoshihiro Momota
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Anesthetic Management ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Anesthesia Induction ◽  
Sagittal Split Ramus Osteotomy ◽  
Junctional Rhythm ◽  
Appropriate Treatment ◽  
Slow Heart Rate

We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR). At 90 minutes after anesthesia induction, local anesthesia with 10 mL of 1% lidocaine and 1:100,000 adrenaline was administered. A junctional rhythm appeared 15 minutes after the local anesthesia. We believe that the atrioventricular nodal pacemaker cells accelerated because of the increased sympathetic activity due to the adrenaline. On the preoperative ECG, the junctional rhythm with slow HR appeared as an escaped beat caused by slowing of the primary pacemaker. Therefore, we think that the preoperative junctional rhythm and the junctional rhythm that appeared during general anesthesia were due to different causes. Understanding the cause of a junctional rhythm could lead to more appropriate treatment. We therefore believe that identifying the cause of the junctional rhythm is important in anesthetic management.

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