The Role of Preemptive Infiltration Anesthesia in the Management of Postoperative Pain Following Septoplasty

Abstract Introduction Septoplasty is one of the most common surgical procedures in rhinology practice. Two major problems encountered after septoplasty are pain and bleeding. Preoperative administration of analgesics before the surgical stimulus, which is the main concept of preemptive analgesia, decreases postoperative pain. Objective The present study was designed to investigate whether preincisional lidocaine infiltration to the subperichondrial area during septoplasty surgery reduced or not postoperative pain and analgesic use. Methods The present prospective, randomized, placebo controlled, double-blind trial was conducted on 64 consecutive patients with nasal septum deviation. Patients were randomly divided into 2 groups; the study group received 2% 20 mg lidocaine/cc (n = 31), and the control group received 6 cc 0.9% NaCl (n = 33). A standard questionnaire was given to each patient to mark his or her pain score between 0 and 10 at the 1st, 3rd, 6th, 12th, and 24th hours. Results The mean and the range of visual analogue scale (VAS) scores of the patients in the study group at the 1st, 3rd, 12th, and 24th hours were 4.03 ± 3.08 (0-10); 3.42 ± 2.39 (0-8); 2.97 ± 2.22 (0-8); 2.87 ± 2.61 (0-9); and 1.94 ± 2.06 (0-9) respectively. The mean and the range of VAS scores of the patients in the control group at the 1st, 3rd, 12th, and 24th hours were 4.12 ± 2.7 (0-10); 3.45 ± 2.4 (0-10); 2.94 ± 2.7 (0-10); 2.79 ± 2.34 (0-10); and 1.5 ± 1.8 (0-6), respectively. The statistical analysis revealed no significant difference among the groups. Conclusion The preemptive local anesthetic administration to the incision area and under the mucoperichondrial flap before septoplasty does not decrease the level of postoperative pain.

The Role of Preemptive Infiltration Anesthesia in the Management of Postoperative Pain Following Septoplasty.

Introduction Septoplasty is one of the most common surgical procedures in rhinology practice. Two major problems encountered after septoplasty are pain and bleeding. Preoperative administration of analgesics before the surgical stimulus, which is the main concept of preemptive analgesia, decreases postoperative pain. Objective The present study was designed to investigate whether preincisional lidocaine infiltration to the subperichondrial area during septoplasty surgery reduced or not postoperative pain and analgesic use. Methods The present prospective, randomized, placebo controlled, double-blind trial was conducted on 64 consecutive patients with nasal septum deviation. Patients were randomly divided into 2 groups; the study group received 2% 20 mg lidocaine/cc ( n = 31), and the control group received 6 cc 0.9% NaCl ( n = 33). A standard questionnaire was given to each patient to mark his or her pain score between 0 and 10 at the 1 st , 3 rd , 6 th , 12 th , and 24 th hours. Results The mean and the range of visual analogue scale (VAS) scores of the patients in the study group at the 1 st , 3 rd , 12 th , and 24 th hours were 4.03 ± 3.08 (0-10); 3.42 ± 2.39 (0-8); 2.97 ± 2.22 (0-8); 2.87 ± 2.61 (0-9); and 1.94 ± 2.06 (0-9) respectively. The mean and the range of VAS scores of the patients in the control group at the 1 st , 3 rd , 12 th , and 24 th hours were 4.12 ± 2.7 (0-10); 3.45 ± 2.4 (0-10); 2.94 ± 2.7 (0-10); 2.79 ± 2.34 (0-10); and 1.5 ± 1.8 (0-6), respectively. The statistical analysis revealed no significant difference among the groups. Conclusion The preemptive local anesthetic administration to the incision area and under the mucoperichondrial flap before septoplasty does not decrease the level of postoperative pain.

Helicobacter pylori in allergic and non-allergic rhinitis does play a protective or causative role?

PURPOSE: Many studies have investigated the effect of Helicobacter pylori (H. pylori) colonization on the development of allergic diseases, but with conflicting results. The purpose of this cross-sectional observation study is to estimate H. pylori prevalence in allergic and nonallergic nasal conditions and compare with normal population. METHODS: 274 patients were tested for H. pylori with stool antigen test. Patients were compared with the control group for H. pylori positivity rates after they were categorized according to their primary diagnoses as mite allergy, pollen allergy, mite and pollen allergy, and non-allergic rhinitis with eosinophilic syndrome (NARES). Results were also classified according to age. RESULTS: The number of H. pylori-positive patients with mite allergy, mite and pollen allergy, and NARES were significantly higher than the control group in sadults. The percentages of patients in the pediatric group who had mite allergy, pollen allergy, mite and pollen allergy, or NARES were not significantly different when compared to the control group. CONCLUSION: Forthcoming studies would undoubtedly evaluate of the profits of treating allergic nasal conditions by treating the aforementioned bacterial infection.

Diagnosis and treatment of laryngopharyngeal reflux: Use of empirical lansoprazole.

The objective of this study was to evaluate the effectiveness of empirical medical treatment in patients with laryngopharyngeal reflux (LPR) disease by scoring the findings and symptoms. Hence, 122 patients were examined at the voice laboratory with a laryngovideostroboscopic device, and all results were recorded for further evaluation. Patients were treated with lansoprazole twice a day. All patients were evaluated before and during the treatment period at the first and third months. The reflux symptom index (RSI) and reflux finding score (RFS) records were correlated and statistically tested to confirm a diagnosis of LPR. The results revealed a significant improvement in the findings and symptoms due to this treatment modality and showed that RFS and RSI were correlated with LPR disease, which can help confirm its diagnosis. Findings and symptom scores before and after the treatment were compared. The differences were statistically significant, which strengthens the reliability of the score indices that were used. This study shows that RFS, RSI, and empirical treatment may be a useful, practical method of diagnosing and following up on LPR. We concluded that it is more efficient to score symptoms and findings together, instead of monitoring pH for 24 hours, in patients with potential LPR.