Efficacy of ultrasound-guided great auricular nerve block with different concentrations of ropivacaine for postoperative analgesia in patients undergoing tympanic and mastoid surgery / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of ultrasound-guided great auricular nerve block with different concentrations of ropivacaine for postoperative analgesia in patients undergoing tympanic and mastoid surgery.Methods Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-60 yr,with body mass index of 19-25 kg/m2,undergoing elective tympanic and mastoid surgery under general anesthesia,were divided into 3 groups (n=30 each) using a random number tablecontrol group (group C),0.25％ ropivacaine group (group R1) and 0.50％ ropivacaine group (group R2).In R1 and R2 groups,great auricular nerve block was performed under ultrasound guidance before anesthesia induction,0.25％ and 0.50％ ropivacaine 2 ml were injected,respectively,10 min later the block in the area innervated by great auricular nerve was evaluated using the method of acupuncture in comparison with the contralateral area.After successful block was confirmed,the patients were ventilated using the laryngeal mask airway under general anesthesia.Flurbiprofen axetil was given as rescue analgesic,sufentanil was used when the efficacy was not satisfactory,and visual analog scale score was maintained less than or equal to 3 points.The number of patients requiring rescue analgesic was recorded within 48 h after surgery.Results The great auricular nerve was successfully blocked in 60 patients of R1 and R2groups.Compared with group C,the requirement for rescue analgesic was significantly decreased within 48 h after surgery in R1and R2 groups (P＜0.01).There was no significant difference in the requirement for rescue analgesic within 48 h after surgery between group R1 and group R2 (P＞0.05).Conclusion Ultrasoundguided great auricular nerve block with 0.25％ ropivacaine provides better efficacy for postoperative analgesia in the patients undergoing tympanic and mastoid surgery.