Effective Local Anesthetic Use in Nasal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Studies
Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery. The primary outcome of this...
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Published in | Plastic and reconstructive surgery. Global open Vol. 11; no. 8; p. e5151 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Lippincott Williams & Wilkins
01.08.2023
Wolters Kluwer |
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Abstract | Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery.
The primary outcome of this systematic review and meta-analysis was postoperative pain scores; secondary outcomes included perioperative opioid requirements, patient satisfaction scores, and time to first analgesic requirement. PubMed, Embase, and MEDLINE databases were searched, and two independent reviewers conducted article screening. Methodological quality assessment of studies utilized the Jadad instrument, and interrater reliability was assessed using Cohen kappa. An inverse-variance, fixed-effects model was used for meta-analysis with Cohen
used to normalize effect size between studies.
and Q statistics were used to assess interstudy variability.
Four studies were included for meta-analysis, totaling 265 randomized patients. The nerve blocks assessed included infraorbital nerve, sphenopalatine ganglion, external nasal nerve, central facial nerve blocks, and total nerve blocks. All demonstrated significantly reduced postoperative pain compared with controls, with a large effect size (
< 0.001). Opioid requirements were lower in the nerve block groups (
< 0.001), and patient satisfaction scores were higher (
< 0.001). Supplemental meta-analyses showed a longer time to first analgesic requirement for patients who received a nerve block (
< 0.001).
These findings support the efficacy of nerve blocks in providing postoperative pain relief and enhancing patient satisfaction with pain management. Perioperative nerve blocks, in combination with general anesthesia, should be considered for postoperative pain control. |
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AbstractList | Background:. Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery. Methods:. The primary outcome of this systematic review and meta-analysis was postoperative pain scores; secondary outcomes included perioperative opioid requirements, patient satisfaction scores, and time to first analgesic requirement. PubMed, Embase, and MEDLINE databases were searched, and two independent reviewers conducted article screening. Methodological quality assessment of studies utilized the Jadad instrument, and interrater reliability was assessed using Cohen kappa. An inverse-variance, fixed-effects model was used for meta-analysis with Cohen d used to normalize effect size between studies. I2 and Q statistics were used to assess interstudy variability. Results:. Four studies were included for meta-analysis, totaling 265 randomized patients. The nerve blocks assessed included infraorbital nerve, sphenopalatine ganglion, external nasal nerve, central facial nerve blocks, and total nerve blocks. All demonstrated significantly reduced postoperative pain compared with controls, with a large effect size (P < 0.001). Opioid requirements were lower in the nerve block groups (P < 0.001), and patient satisfaction scores were higher (P < 0.001). Supplemental meta-analyses showed a longer time to first analgesic requirement for patients who received a nerve block (P < 0.001). Conclusions:. These findings support the efficacy of nerve blocks in providing postoperative pain relief and enhancing patient satisfaction with pain management. Perioperative nerve blocks, in combination with general anesthesia, should be considered for postoperative pain control. Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery. MethodsThe primary outcome of this systematic review and meta-analysis was postoperative pain scores; secondary outcomes included perioperative opioid requirements, patient satisfaction scores, and time to first analgesic requirement. PubMed, Embase, and MEDLINE databases were searched, and two independent reviewers conducted article screening. Methodological quality assessment of studies utilized the Jadad instrument, and interrater reliability was assessed using Cohen kappa. An inverse-variance, fixed-effects model was used for meta-analysis with Cohen d used to normalize effect size between studies. I2 and Q statistics were used to assess interstudy variability. ResultsFour studies were included for meta-analysis, totaling 265 randomized patients. The nerve blocks assessed included infraorbital nerve, sphenopalatine ganglion, external nasal nerve, central facial nerve blocks, and total nerve blocks. All demonstrated significantly reduced postoperative pain compared with controls, with a large effect size (P < 0.001). Opioid requirements were lower in the nerve block groups (P < 0.001), and patient satisfaction scores were higher (P < 0.001). Supplemental meta-analyses showed a longer time to first analgesic requirement for patients who received a nerve block (P < 0.001). ConclusionsThese findings support the efficacy of nerve blocks in providing postoperative pain relief and enhancing patient satisfaction with pain management. Perioperative nerve blocks, in combination with general anesthesia, should be considered for postoperative pain control. Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery. Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery. The primary outcome of this systematic review and meta-analysis was postoperative pain scores; secondary outcomes included perioperative opioid requirements, patient satisfaction scores, and time to first analgesic requirement. PubMed, Embase, and MEDLINE databases were searched, and two independent reviewers conducted article screening. Methodological quality assessment of studies utilized the Jadad instrument, and interrater reliability was assessed using Cohen kappa. An inverse-variance, fixed-effects model was used for meta-analysis with Cohen used to normalize effect size between studies. and Q statistics were used to assess interstudy variability. Four studies were included for meta-analysis, totaling 265 randomized patients. The nerve blocks assessed included infraorbital nerve, sphenopalatine ganglion, external nasal nerve, central facial nerve blocks, and total nerve blocks. All demonstrated significantly reduced postoperative pain compared with controls, with a large effect size ( < 0.001). Opioid requirements were lower in the nerve block groups ( < 0.001), and patient satisfaction scores were higher ( < 0.001). Supplemental meta-analyses showed a longer time to first analgesic requirement for patients who received a nerve block ( < 0.001). These findings support the efficacy of nerve blocks in providing postoperative pain relief and enhancing patient satisfaction with pain management. Perioperative nerve blocks, in combination with general anesthesia, should be considered for postoperative pain control. |
Author | Cordero, Justin Vyas, Raj M Arora, Jagmeet Pfaff, Miles J Stulginski, Avril Alaniz, Leonardo Zhu, Xiao Vu, Cindy |
Author_xml | – sequence: 1 givenname: Leonardo surname: Alaniz fullname: Alaniz, Leonardo organization: Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif – sequence: 2 givenname: Cindy surname: Vu fullname: Vu, Cindy organization: From the School of Medicine, University of California Irvine, Irvine, Calif – sequence: 3 givenname: Jagmeet surname: Arora fullname: Arora, Jagmeet organization: From the School of Medicine, University of California Irvine, Irvine, Calif – sequence: 4 givenname: Avril surname: Stulginski fullname: Stulginski, Avril organization: From the School of Medicine, University of California Irvine, Irvine, Calif – sequence: 5 givenname: Xiao surname: Zhu fullname: Zhu, Xiao organization: Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa – sequence: 6 givenname: Justin surname: Cordero fullname: Cordero, Justin organization: University of California Riverside, School of Medicine, Riverside, Calif – sequence: 7 givenname: Raj M surname: Vyas fullname: Vyas, Raj M organization: Pediatric Plastic Surgery, Children's Hospital of California, Orange, Calif – sequence: 8 givenname: Miles J surname: Pfaff fullname: Pfaff, Miles J organization: Pediatric Plastic Surgery, Children's Hospital of California, Orange, Calif |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37534108$$D View this record in MEDLINE/PubMed |
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Snippet | Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze... Background:. Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was... |
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Title | Effective Local Anesthetic Use in Nasal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Studies |
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