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Role of local anaesthetic nerve block in endoscopic sinus surgery: A systematic review and meta‐analysis
Author(s) -
Shamil E.,
Rouhani M.J.,
Basetti S.,
Bast F.,
Hopkins C.,
Surda P.
Publication year - 2018
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13128
Subject(s) - medicine , meta analysis , adverse effect , medline , randomized controlled trial , endoscopic sinus surgery , quality of evidence , study heterogeneity , surgery , systematic review , local anaesthetic , anesthesia , political science , law
Objective The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS). Design The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the Ovid portal (1946‐2017). Results Seven randomised controlled trials were included. Due to considerable heterogeneity of data, only two studies were pooled into meta‐analysis which demonstrated a statistically significantly better surgical field quality during ESS in the LAB group compared with the control group (MD −0.86; 95% CI −2.24, 0.51; P = .009). No adverse events related to LAB toxicity were reported. Conclusions Sphenopalatine ganglion LAB with adrenaline carries relatively low risk of morbidity, but may improve the quality of the surgical field in terms of bleeding. However, there are limitations of the study due to heterogeneity of methods, quality and size of the studies. Well‐conducted large RCTs are needed using standardised inclusion criteria, balanced baseline characteristics of cohorts, and validated subjective and objective outcome measures.