Results of Endoscopic Dacryocystorhinostomy under Local Anesthesia with Minimal Sedation.

Woong Chul Choi,Sang Hee Doh,Ji-Sun Paik

doi:10.1155/2017/6712491

Woong Chul Choi, Sang Hee Doh + Show 1 more

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https://doi.org/10.1155/2017/6712491

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Abstract

Purpose We evaluated the tolerability and efficacy of endoscopic dacryocystorhinostomy (Endo-DCR) in patients treated in the leaning position and under local anesthesia with minimal sedation (LAS). Study Design Questionnaire to determine subjective success of Endo-DCR. Methods From May 2013 to August 2014, a total of 95 eyes with epiphora presented to the Myoung Eye Plastic Surgery Clinic in Seoul, Korea, and were treated with Endo-DCR under LAS. Three nerve blocks were administered to achieve local anesthesia. Postoperatively, the wound site was packed with Nasopore to control bleeding and promote wound healing. Outcome measures included a patient questionnaire completed on postoperative day 7 to evaluate intraoperative and postoperative pain based on the VAS (0 to 10). Results Mean intraoperative and postoperative pain scores were 1.03 and 1.64, respectively, for 95 eyes. Of the 95 eyes treated, the patients in 82 eyes (86.31%) reported that they would prefer LAS over GA for a repeat Endo-DCR. The subjective and objective surgical success rates were 90.14% and 95.77%, respectively. Conclusions Endo-DCR carried out under LAS with the patient in the leaning position is more useful, efficient, and feasible than Endo-DCR performed under GA with the patient in the supine position.

Highlights

Since external dacryocystorhinostomy (Ext-DCR) was first described in 1904 by Toti [1], various techniques for endoscopic dacryocystorhinostomy (Endo-DCR) have been developed, and overall success rates for both procedures have been reported to be as high as 95% [2]
Because general anesthesia (GA) can pose many problems, such as intraoperative bleeding and postoperative epistaxis [5], various local anesthesia (LA) techniques have been introduced by Hurwitz et al [6], Fanning
We evaluated the tolerability and efficacy of Endo-DCR performed with the patient in the sitting position under local anesthesia with sedation (LAS)

Summary

Introduction

Since external dacryocystorhinostomy (Ext-DCR) was first described in 1904 by Toti [1], various techniques for endoscopic dacryocystorhinostomy (Endo-DCR) have been developed, and overall success rates for both procedures have been reported to be as high as 95% [2]. Because GA can pose many problems, such as intraoperative bleeding and postoperative epistaxis [5], various LA techniques have been introduced by Hurwitz et al [6], Fanning [7], Smith et al [8], and Maheshwari [9]. Such techniques reduce the risks associated with GA (e.g., postoperative nausea and vomiting) and enable shorter operation times and faster recovery. The visual analogue scale (VAS) was used to determine patients’ perceptions of pain, a postoperative questionnaire was used to evaluate subjective success, and the nasolacrimal syringing test was employed to determine objective improvements

Methods

Results

7-8 Hurts a whole lot

Discussion

Ethical Approval