Regional anaesthesia for outpatient nasal surgery

Abstract

Regional anaesthesia is not used widely for outpatient nasal surgery. The aim of this study was to determine the role of nasociliary and infraorbital nerve block in 24 patients undergoing nasal surgery comprising: cosmetic or reconstructive surgery of the nose and surrounding soft tissue, polypal removal, turbinectomy, reduction of fractured nasal bones, small tumour resection or emergency surgery on isolated facial lacerations. Mild sedation with midazolam 0.03 mg kg-1 was used before anaesthesia. Nasociliary and infraorbital blocks were technically easy to perform, safe and provided good intraoperative conditions. Only minor complications were observed, including local bruising in eight patients and transient diplopia in one patient. No patient received general anaesthesia, but infiltration of local anaesthetic was necessary in four patients because of incomplete anaesthesia in the surgical area. Operative conditions were judged as good or excellent by surgeons in 20 of 24 patients. Twenty of 24 patients were very satisfied or satisfied with anaesthesia. Duration of surgery exceeding 60 min and excessive bleeding in the nasopharynx were the main limiting factors for the use of facial regional anaesthesia.