Ferda Ciftci1, Sibel Pocan, Koray Karadayi, Oguz Gulecek. 1. Department of Ophthalmology, Gulhane Military Medical Academy, GATA Haydarpasa Training Hospital, Istanbul, Turkey. ciftciferda@yahoo.com
Abstract
PURPOSE: To compare the effectiveness, complications, and patient acceptance of local anesthesia with general anesthesia in young patients for external dacryocystorhinostomy (DCR). METHODS: Data were prospectively collected over an 8-year period (1996-2004) on young patients (mean age: 22.64+/-1.71) undergoing external DCR in Gulhane Military Medical Academy. Patients were randomly allocated in two groups: general anesthesia (GA) and local anesthesia (LA). Of the 480 DCR procedures, 182 were performed with general anesthesia (44 bilateral), 298 were performed with local anesthesia (32 bilateral). Visual analogue scales were recorded in the postoperative 2-hour period. Postoperative nausea and vomiting (PONV), epistaxis, length of hospital stay, and intraoperative bleeding were noted. RESULTS: Patients in both groups reported being comfortable during and immediately after surgery. Only 2 patients in the LA group required additional local anesthetic because of pain. Intraoperative bleeding was lower in the LA group. Analgesic requirement and signs of nausea and vomiting in the GA group were higher in the early postoperative period (p<0.05). The incidence of PONV was higher (p<0.05) in the GA group. Postoperative epistaxis was observed in 12 patients in the GA group and just 2 patients in the LA group. Length of hospital stay was 2.29+/-0.46 days in the GA group, and 1.23+/-0.42 days in the LA group (p<0.01). CONCLUSIONS:Local anesthesia in DCR is safe and comfortable when proper anatomical approach to nerve blocks is performed correctly. Local anesthesia in young patients undergoingexternal DCR is a good alternative because it is cost-effective and it eliminates the complications of general anesthesia.
RCT Entities:
PURPOSE: To compare the effectiveness, complications, and patient acceptance of local anesthesia with general anesthesia in young patients for external dacryocystorhinostomy (DCR). METHODS: Data were prospectively collected over an 8-year period (1996-2004) on young patients (mean age: 22.64+/-1.71) undergoing external DCR in Gulhane Military Medical Academy. Patients were randomly allocated in two groups: general anesthesia (GA) and local anesthesia (LA). Of the 480 DCR procedures, 182 were performed with general anesthesia (44 bilateral), 298 were performed with local anesthesia (32 bilateral). Visual analogue scales were recorded in the postoperative 2-hour period. Postoperative nausea and vomiting (PONV), epistaxis, length of hospital stay, and intraoperative bleeding were noted. RESULTS:Patients in both groups reported being comfortable during and immediately after surgery. Only 2 patients in the LA group required additional local anesthetic because of pain. Intraoperative bleeding was lower in the LA group. Analgesic requirement and signs of nausea and vomiting in the GA group were higher in the early postoperative period (p<0.05). The incidence of PONV was higher (p<0.05) in the GA group. Postoperative epistaxis was observed in 12 patients in the GA group and just 2 patients in the LA group. Length of hospital stay was 2.29+/-0.46 days in the GA group, and 1.23+/-0.42 days in the LA group (p<0.01). CONCLUSIONS: Local anesthesia in DCR is safe and comfortable when proper anatomical approach to nerve blocks is performed correctly. Local anesthesia in young patients undergoing external DCR is a good alternative because it is cost-effective and it eliminates the complications of general anesthesia.
Authors: Mehmet Kelles; M Tayyar Kalcioglu; Emine Samdanci; Erol Selimoglu; Mustafa Iraz; Murat Cem Miman; Ibrahim C Haznedaroglu Journal: Curr Ther Res Clin Exp Date: 2011-10
Authors: Miroslav M Knežević; Gordana P Vlajković; Milenko Ž Stojković; Dejan M Rašić; Branislav R Stanković; Marija M Božić Journal: Med Sci Monit Date: 2012-05