Bupivacaine improves surgical field and postoperative pain control in endoscopic sinus surgery: a clinical trial

Abstract

Abstract Introduction Endoscopic sinus surgery is often challenging because of bleeding and pain. A variety of techniques have been explored to reduce surgical function and pain, with the sphenopalatine ganglion block showing the most promising results. All of these researches, however, had methodological flaws since saline was used as a placebo injection, which could have irritated the ganglion and produced less-than-ideal results, in accordance with our theory. Aim and objective To determine the effect of sphenopalatine ganglion block with bupivacaine on intraoperative endoscopic surgical field and postoperative pain. Patients and methods A prospective double blind, randomized study was conducted in 50 subjects undergoing endoscopic sinus surgery for chronic rhinosinusitis with or without polyp. The case group received 1.5 ml of 0.5% bupivacaine in sphenopalatine ganglion block while control group didn’t receive any drug in ganglion. The intra-operative surgical field grade and postoperative pain score was recorded to analyze the effect of the block. Results We discovered a statistically significant difference in the endoscopic surgical field between the case and control groups. In comparison to the control group, the surgical field was more visible in the sphenopalatine ganglion block group. The case group significantly outperformed the control group in terms of pain visual analogue score throughout the observation period, with the exception of the first day following surgery. Conclusion Sphenopalatine ganglion block with bupivacaine 0.5% is a straightforward, efficient, and secure way to improve the endoscopic surgical field and lessen postoperative pain in patients undergoing endoscopic sinus surgery.

Keywords

• Trans-nasal endoscopic surgery
• Sinusitis
• Bupivacaine
• Postoperative pain
• Endoscopic hemostasis