A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia
ABSTRACTObjective: Evaluation of the analgesic efficacy and safety of ultrasound-guided pterygopalatine fossa (PPF) block in patients undergoing maxillofacial cancer surgeries under general anesthesia.Methods: Forty-eight patients scheduled for maxillofacial cancer surgeries enrolled in the study we...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2021.1903667 |
| _version_ | 1797683783119405056 |
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| author | Ekramy M Abdelghafar Dina Nabil Abbas Ahmed Othman Sherif Bahaa Elddin Zayed Ashraf Hamed Shawki |
| author_facet | Ekramy M Abdelghafar Dina Nabil Abbas Ahmed Othman Sherif Bahaa Elddin Zayed Ashraf Hamed Shawki |
| author_sort | Ekramy M Abdelghafar |
| collection | DOAJ |
| description | ABSTRACTObjective: Evaluation of the analgesic efficacy and safety of ultrasound-guided pterygopalatine fossa (PPF) block in patients undergoing maxillofacial cancer surgeries under general anesthesia.Methods: Forty-eight patients scheduled for maxillofacial cancer surgeries enrolled in the study were randomly allocated into group (A): ultrasound-guided bilateral PPF block using local anesthetic; and group (B): ultrasound-guided bilateral PPF injection with saline. Our primary outcome was assessing postoperative analgesia using visual analog scale and the amount of nalbuphine used for rescue analgesia.We recorded the operative field’s quality, end-tidal sevoflurane concentration, the total amount of nitroglycerin used to achieve the target mean arterial pressure (MAP) of 60–65 mmHg, the frequency of propranolol usage, emergence time and Aldrete score.Results: The VAS score was significantly lower in group A than group B until the 18th postoperative hour (P < 0.0001). The number of patients required nalbuphine (12 versus 24 patients) and total nalbuphine doses were significantly less in group A (10 ± 2 mg) versus group B (20 ± 5 mg) (P < 0.01). Sevoflurane mean end-tidal concentration was significantly less in group A (2.2 ± 0.53%) than in Group B (2.7 ± 0.48%), P-value = 0.019. Total nitroglycerine dose was significantly lower (2.45 ± 0.63 µg/kg/min) in group A than (3.58 ± 0.77 µg/kg/min) in group B (P value<0.05).Conclusions: ultrasound-guided PPF block combined with general anesthesia is a safe technique and helps in providing better operative field by adequate control over the blood pressure. It is effective for decreasing the postoperative pain and analgesic requirements in patients undergoing maxillofacial cancer surgery. |
| first_indexed | 2024-03-12T00:19:51Z |
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| id | doaj.art-07134feaaf3d4cf6b3712e56a92942b1 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-03-12T00:19:51Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-07134feaaf3d4cf6b3712e56a92942b12023-09-15T13:38:33ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492021-01-0137115916610.1080/11101849.2021.1903667A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General AnesthesiaEkramy M Abdelghafar0Dina Nabil Abbas1Ahmed Othman2Sherif Bahaa Elddin Zayed3Ashraf Hamed Shawki4Assistant Professor of Anesthesia and Pain Relief NCI, Cairo University, Giza, EgyptProfessor of Anesthesia and Pain Relief NCI, Cairo University, Giza, EgyptAssistant Professor of Anesthesia, ICU and Pain Relief, South Egypt Cancer Institute, Assiut University, Assiut, EgyptAssistant Professor of Surgical Oncology, NCI, Cairo University, Giza, EgyptLecturer of Surgical Oncology NCI, Cairo University, Giza, EgyptABSTRACTObjective: Evaluation of the analgesic efficacy and safety of ultrasound-guided pterygopalatine fossa (PPF) block in patients undergoing maxillofacial cancer surgeries under general anesthesia.Methods: Forty-eight patients scheduled for maxillofacial cancer surgeries enrolled in the study were randomly allocated into group (A): ultrasound-guided bilateral PPF block using local anesthetic; and group (B): ultrasound-guided bilateral PPF injection with saline. Our primary outcome was assessing postoperative analgesia using visual analog scale and the amount of nalbuphine used for rescue analgesia.We recorded the operative field’s quality, end-tidal sevoflurane concentration, the total amount of nitroglycerin used to achieve the target mean arterial pressure (MAP) of 60–65 mmHg, the frequency of propranolol usage, emergence time and Aldrete score.Results: The VAS score was significantly lower in group A than group B until the 18th postoperative hour (P < 0.0001). The number of patients required nalbuphine (12 versus 24 patients) and total nalbuphine doses were significantly less in group A (10 ± 2 mg) versus group B (20 ± 5 mg) (P < 0.01). Sevoflurane mean end-tidal concentration was significantly less in group A (2.2 ± 0.53%) than in Group B (2.7 ± 0.48%), P-value = 0.019. Total nitroglycerine dose was significantly lower (2.45 ± 0.63 µg/kg/min) in group A than (3.58 ± 0.77 µg/kg/min) in group B (P value<0.05).Conclusions: ultrasound-guided PPF block combined with general anesthesia is a safe technique and helps in providing better operative field by adequate control over the blood pressure. It is effective for decreasing the postoperative pain and analgesic requirements in patients undergoing maxillofacial cancer surgery.https://www.tandfonline.com/doi/10.1080/11101849.2021.1903667Pterygopalatine fossaultrasonographymaxillofacialanalgesiablock |
| spellingShingle | Ekramy M Abdelghafar Dina Nabil Abbas Ahmed Othman Sherif Bahaa Elddin Zayed Ashraf Hamed Shawki A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia Egyptian Journal of Anaesthesia Pterygopalatine fossa ultrasonography maxillofacial analgesia block |
| title | A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia |
| title_full | A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia |
| title_fullStr | A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia |
| title_full_unstemmed | A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia |
| title_short | A Prospective, Randomized Clinical Trial to Evaluate Analgesic Efficacy of Bilateral Pterygopalatine Fossa Injection in Patients Undergoing Maxillofacial Cancer Surgeries Under General Anesthesia |
| title_sort | prospective randomized clinical trial to evaluate analgesic efficacy of bilateral pterygopalatine fossa injection in patients undergoing maxillofacial cancer surgeries under general anesthesia |
| topic | Pterygopalatine fossa ultrasonography maxillofacial analgesia block |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2021.1903667 |
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