Comparative study between selective nerve blocks and the intravenous opioids in mastoid surgery

Publication date: Available online 17 June 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Santosh Kumar Swain, Chandrasekhar Pradhan, Sidharth Mohanty, Mahesh Chandra Sahu
ObjectiveThis double-blind randomized trial was conducted to compare the efficacy of selective nerve blocks over intravenous use of morphine during mastoid surgery.Materials and methodsA total of 50 patients between the ages 25 to 45years were divided into two groups as per the anaesthetic techniques used; nerve block group (N) and intravenous morphine group (M). After induction of general anaesthesia and before surgical incision: Group N patients (nerve block group) were given Great Auricular Nerve (GAN) and Auriculo-Temporal Nerve (ATN) block with 0.25% bupivacaine. Group M patients (morphine group) received 0.1mg/kg morphine. In the post anaesthesia care unit (PACU), Visual Analogue Scale (VAS) was used to assess post operative pain, Ramsay Sedation Scale (RSS) for sedation and post operative nausea and vomiting (PONV) impact scale score.ResultsVAS scores and requirement of rescue analgesics in the PACU was significantly less in the N Group for first 3h. The group N patients had a less frequent incidence of vomiting requiring intervention and were ready to be discharged from hospital after 3h of surgery.ConclusionCombination of GAN and ATN block with general anaesthesia is an uncomplicated, effective and well tolerated method for the safe conduct of mastoid surgery.



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