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

Ghanem, Mohamed T.; Elmalt, Ashraf

doi:10.4103/roaic.roaic_111_16

Cited by 5 publications

(8 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…38,[51][52][53] The initial discomfort associated with local anaesthetic blocks in the awake patient can be mitigated through slow infiltration and use of a fine 27-gauge needle. 19,54 Procedures performed under local anaesthetic permit shorter total operative and recovery times 19,23 and help release anaesthetic capacity for other operating theatres. 51 Fedok et al 29 reported local anaesthetic procedures reduced total operative time by up to 22 per cent when compared with general anaesthetic.…”

Section: Discussionmentioning

confidence: 99%

“…Faster recovery combined with reduced admission rate and lack of anaesthetist therefore reduces the procedure costs of local anaesthetic. 19,23 Patient preference is perhaps even more important; Caner et al found 89 per cent of patients would choose to reselect future procedures to be performed under local anaesthetic. 51 A dedicated time-and-motion study looking at local anaesthetic endoscopic sinus surgery may help quantify the relative cost-benefits over and above operating under sedation or general anaesthetic.…”

Section: Discussionmentioning

confidence: 99%

“…Non-intubated patients can be positioned more upright; for example, the reverse Trendelenburg position provides 15° of head elevation. 22,23 This increases venous drainage of the head and neck as blood pools in the lower extremities. 24 Every 2.5 cm elevation above the level of the heart corresponds with a 2 mmHg reduction in mean arterial blood pressure.…”

Section: Discussionmentioning

confidence: 99%

“…35 Although rare, intentional hypotension is not without consequence and theoretically may engender cerebral thrombosis, renal hypoperfusion and myocardial infarction. 23,36,37 The techniques outlined in this paper recommend the initial use of Lignospan (2 per cent lidocaine + 1:80 000 adrenaline). In addition to providing topical anaesthesia, this decongestant acts as a potent vasoconstrictor which aids mucosal decongestion and reduces haemorrhage, mitigating the hypotensive benefits seen in general anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Local anaesthetic techniques in endoscopic sinonasal surgery: a contemporaneous review

et al. 2021

View full text Add to dashboard Cite

Objective Endoscopic endonasal surgery is a minimally invasive technique that has revolutionised the management of complex neurosurgical, otolaryngological, skull-base and craniofacial lesions. Traditionally performed under general anaesthetic, this study explores the growing role of local anaesthetic techniques. Method A contemporaneous review of modified dental techniques and intraoral anatomy provides a supportive guide for performing endoscopic sinus surgery under local anaesthetic. Results The practical procedures for four midfacial nerve blocks are described with relevance to endoscopic surgery under local anaesthetic. Anatomy, surgical technique and potential complications are discussed for the incisive foramen block, sphenopalatine ganglion block (via endonasal approach), maxillary nerve block (via the greater palatine foramen and the transoral lateral pterygoid plate approach) and transcutaneous approach to the pterygomaxillary fissure. Conclusion Ultimately, such techniques may extend the safety and efficacy of endoscopic sinus surgery, limit surgical risk and increase satisfaction for patients, surgeons and healthcare managers alike.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Local anaesthetic techniques in endoscopic sinonasal surgery: a contemporaneous review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Facilitated by new techniques and developments in technology, awake surgery is already an established method applicable to many rhinology procedures and it has been widely adopted in the USA [ 13 ] and in some European countries. Where similar outcomes can be achieved, awake surgery offers many advantages over general anaesthetic (GA), requiring fewer staff and typically resulting in a shorter hospital stay and faster recovery [ 14 , 15 , 16 ]. Furthermore, awake surgery can be performed safely and efficiently outside of traditional surgical theatres, presenting an opportunity to leverage unused capacity in alternate sites, often outside of major hospitals.…”

Section: Introductionmentioning

confidence: 99%

Awake Rhinology Surgery in Response to the COVID-19 Pandemic in Europe

Andrews

Anschuetz

Baptista

et al. 2021

ORL

View full text Add to dashboard Cite

Background: European health-care systems are faced with a backlog of surgical procedures following the suspension of routine surgery during the COVID-19 crisis. Routine rhinology surgery under general anaesthetic (GA) is now faced with significant challenges which include limited theatre capacity, the negative ramifications of surgical prioritization, reduced patient throughput in secondary care, and additional personal protective equipment requirements. Delayed surgery in rhinology, particularly with regards to chronic rhinosinusitis, has previously been shown to have poorer surgical outcomes, a detrimental effect on quality of life and long-term negative health socio-economic effects. Awake rhinology surgery under local anaesthetic (LA) provides an ideal alternative to GA. It provides a means of operating on patients in a setting alternative to currently oversubscribed main theatres, by utilizing satellite facilities, while ensuring identical surgical outcomes for patients who may otherwise have been forced to wait a long time for their procedure. It also confers additional benefits in terms of shorter recovery time and hospital stay for patients. Objectives: We have developed a set of recommendations that are intended to help support clinicians and managers to better adopt LA rhinology protocols and minimize the risk to the patient and health-care professionals involved. Methodology: International roundtable forums were conducted and supplemented by individual interviews. The international board consisted of 12 rhinologists experienced in awake rhinology surgery. Feedback was analysed and shared to develop a consensus of best practice. Recommendations: Local and national guidelines need to be adhered to with specific focus on patient and clinician safety. When performing awake rhinology procedures in the COVID-19 recovery process, consider implementing specific safety measures and workflow practices to safeguard patients and staff and minimize the risk of infection. Conclusion: Awake surgery potentially provides quicker access to routine rhinology surgery in the post-COVID-19 recovery phase, ensuring patients are treated in a timely matter, thereby avoiding higher downstream costs, and improving outcomes.

show abstract

Comparison between combined regional nasal block and general anesthesia versus general anesthesia with dexmedetomidine during endoscopic sinus surgery

Hamouda

Salama

Hassan

et al. 2023

Egyptian Journal of Anaesthesia

View full text Add to dashboard Cite

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

Cited by 5 publications

References 1 publication

Local anaesthetic techniques in endoscopic sinonasal surgery: a contemporaneous review

Local anaesthetic techniques in endoscopic sinonasal surgery: a contemporaneous review

Awake Rhinology Surgery in Response to the COVID-19 Pandemic in Europe

Comparison between combined regional nasal block and general anesthesia versus general anesthesia with dexmedetomidine during endoscopic sinus surgery

Contact Info

Product

Resources

About