Vol.101 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 4 April 2008
Intra-Operative Pain during Endoscopic Sinus
Surgery under Local Anesthesia
Atsuhito Takahashi, Kazuhiko Shoji, Tsuyoshi Kojima,
Takehiro Iki and Masanobu Mizuta
(Tenri Hospital)
Endoscopic sinus surgery (ESS) is a well-documented procedure that has been used worldwide. Patients can undergo surgery under either local or general anesthesia. Under local anesthesia, one of the important issues for patients is the degree of intra-operative pain. We should perform the procedure without causing unbearable pain. This study evaluated the degree of intra-operative pain during ESS under local anesthesia and the ability of patients to cope with unbearable pain. Twenty-one patients were entered into this study (10 men, 11 women) operated by one surgeon between March 2006 and June 2007. During the first 9 months, 11 patients underwent the procedure without the maxillary nerve block. During the next 7 months, 10 patients were managed with the maxillary nerve block. The severity of pain was scored by the patient on a numerical rating scale (NRS). Pain severity was indicated by the number (minimum 0 and maximum 5).
Eleven patients without the block reported pain during of the opening maxillary sinus (average of score 2.91). However 10 patients with the block reported that there was little pain (score average 0.95). The difference between the two groups was significant. We confirmed the degree of the intra-operative pain during ESS and that pain could be successfully managed by maxillary nerve block. NRS is a useful tool to evaluate intra-operative pain under local anesthesia, because we can hear a report of the pain score even without visually monitoring the tool (NRS).
Key words :intra-operative pain, endoscopic sinus surgery (ESS), maxillary nerve block, numerical rating scale (NRS)