Open AccessComparative study between selective nerve blocks and the intravenous opioids in mastoid surgery
Author(s) -
Santosh Kumar Swain,
Chandrasekhar Pradhan,
Sujata Mohanty,
Mahesh Chandra Sahu
Publication year - 2017
Publication title -
egyptian journal of ear nose throat and allied sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.108
H-Index - 8
eISSN - 2090-3405
pISSN - 2090-0740
DOI - 10.1016/j.ejenta.2017.05.004
Subject(s) - pacu , medicine , anesthesia , visual analogue scale , sedation , surgery , nausea , morphine , postoperative nausea and vomiting , vomiting , randomized controlled trial , bupivacaine , analgesic , general anaesthesia , nerve block
Objective: This double-blind randomized trial was conducted to compare the efficacy of selective nerve blocks over intravenous use of morphine during mastoid surgery. Materials and methods: A total of 50 patients between the ages 25 to 45Â years were divided into two groups as per the anaesthetic techniques used; nerve block group (N) and intravenous morphine group (M). After induction of general anaesthesia and before surgical incision: Group N patients (nerve block group) were given Great Auricular Nerve (GAN) and Auriculo-Temporal Nerve (ATN) block with 0.25% bupivacaine. Group M patients (morphine group) received 0.1Â mg/kg morphine. In the post anaesthesia care unit (PACU), Visual Analogue Scale (VAS) was used to assess post operative pain, Ramsay Sedation Scale (RSS) for sedation and post operative nausea and vomiting (PONV) impact scale score. Results: VAS scores and requirement of rescue analgesics in the PACU was significantly less in the N Group for first 3Â h. The group N patients had a less frequent incidence of vomiting requiring intervention and were ready to be discharged from hospital after 3Â h of surgery. Conclusion: Combination of GAN and ATN block with general anaesthesia is an uncomplicated, effective and well tolerated method for the safe conduct of mastoid surgery. Keywords: Mastoid surgery, Auriculo-Temporal Nerve block, Great Auricular Nerve block, Morphin