International Archives of Otorhinolaryngology (Mar 2010)
Pain and intra-operative amnesia evaluation with local anesthesia and sedation in patients subjected to rhinosseptoplasties
Abstract
Introduction: The local anesthesia practice and sedation to rhinoplasty and others aesthetics procedures of the face are each time more frequents. In the Brazil, the Federal Council of Medicine defines it and regulate its practice. Objective: To analyze the analgesia' effectiveness and of the intro operative amnesia through analogous visual and subjective scales in the rhinosseptoplasties performed under local anesthesia and sedation, looking for associations with the medium quantities of medication utilized. Method: A retrospective study based in reports relatives to 158 aesthetic-functional rhinoplasties. The surgeon recorded in a protocol the data relatives to the use of local anesthetics and sedatives (including concentration and quantities utilized) as well as the side effects. In the first return post surgery the patient quantifies the pain that he felt in the intra operative utilizing a analogous visual scale as described by Hasen and collaborators. The Amnesia considered ideal when the patient referred to remind "nothing" or "a few of the procedure. Results: The sample constituted of 80 (73,4%) women and 29 )26,6%) men, average of age of 29,3 ± 9,5 years. The median of the pain by the analogous visual scale was 0,05; 80% under 3,35. The amnesia was ideal in 51 (46,8%) surgeries. The midazolam was utilized in all the surgeries. Fentanyl in 32 (29,4%) and, pethidine in 77 (70,6%). Had not statistically significants differences between the quantities of medication utilized between the groups of patients with ideal amnesia when compared with those that do not obtained satisfactory amnesia. Conclusion: Local anesthesia and sedation in rhinoplasties are comfortable and secures in the majority of the cases, even without have a satisfactory amnesia.
