Pain and safety in otorhinolaryngologic procedures under local anesthesia

Abstract

Objectives: The aim of this study was to determine safety, pain perception, and the factors that may affect pain perception in patients undergoing certain otorhinolaryngologic procedures under local anesthesia with sedation.

Design: Prospective clinical study.

Setting: Tertiary care academic medical centre.

Methods: Two hundred thirteen patients operated on under local anesthesia with sedation were included in the study. A visual analogue scale (VAS) and a questionnaire were employed to measure pain perception during surgery and evaluate possible pain-related variables.

Results: The mean VAS values were 2.86 (+/-1.84) for the myringoplasty group, 2.54 (+/-1.76) for the otosclerosis surgery group, 1.70 (+/-1.25) for the somnoplasty group, 1.00 (+/-0.94) for the oral biopsy group, 2.15 (+/-1.49) for the inferior turbinate radiofrequency reduction (ITRR) group, 3.47 (+/-2.18) for the septoplasty plus ITRR group, 5.56 (+/-2.01) for the septorhinoplasty group, 4.94 (+/-2.16) for the open technique septoplasty group, and 3.30 (+/-1.87) for the septoplasty group. No variable was shown to affect pain perception when all patients were evaluated in common. When surgical procedures were evaluated individually, the level of acquaintance of patients in the myringoplasty group (p=.007) and operative time for the septoplasty group (p<.001) were found to independently affect pain perception.

Conclusions: Given that septorhinoplasty and open technique septoplasty are found to be more painful, it is advisable to perform these procedures under general anesthesia. To increase the level of acquaintance of patients and to shorten operative time as possible may be helpful for minimizing pain perception.