Combined great auricular nerve block and general anesthesia for tympanomastoid surgery

ABSTRACT

The effects of the great auricular nerve [GAN] block combined with general anaesthesia [GA] in patients undergoing tympanomastoid surgery have been evaluated with respect to the quality of the surgical field, isoflurance consumption, postoperative pain and recovery profile. Thirty adult patients were randomly allocated to receive GA alone [group I, n=15] or combined GA and GAN block [group II, n=15]. After stabilization of GA with isoflurane, N[2]O/O[2] the patients in group II received GAN block The mean arterial pressure [MAP] intraoperatively was maintained at 60-65 mmHg by adjusting the concentration of isoflurane and the use of hypotensive agent [esmolol]. The consumption of isoflurane, and the frequency of esmolol use were evaluated in both groups. The surgeon evaluated the quality of surgical field. The pain intensity, postoperative morphine consumption and incidence of nausea were evaluated in PACU. Intraoperatively, isoflurane consumption was less in group II than group I [P<0.005]. The number of patients requiring esmolol were significantly higher in group I. The average category scale for quality of surgical field was better in group II than group I in the range of MAP 60-65 mmHg .In the PACU, the total morphine consumption were significantly reduced in group II than group I [P Postoperative pain scores were lower in group II until 120 min. The incidence of nausea was reduced in group II [20% vs 46%]. The duration of stay in the PACU were not significantly different in the two groups. GAN block is effective as an adjuvant to GA in patients undergoing tympanomastoid surgery to reduce isoflurane consumption, use of hypotensive agents postoperative morphine consumption and postoperative pain with better recovery profile