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Evidence-based Practice and Quality Improvement

General anesthesia versus monitored anesthetic care with dexmedetomidine for closed reduction of nasal bone fracture

1AP4-6

Lee, S.; Lee, K.; Kim, K. -M.; Yoo, B.; Yon, J.

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European Journal of Anaesthesiology (EJA): June 2013 - Volume 30 - Issue - p 17-17
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Background and Goal of Study: Reduction of nasal bone fracture can be performed under general or local anesthesia. The aim of this study is to compare general anesthesia (GA) and monitored anesthetic care (MAC) with dexmedetomidine on the basis of intra-operative vital signs, comfort of patients and surgeons and the adverse effects after closed reduction of nasal bone fracture.

Materials and Methods: Sixty patients with ASA class I or II were divided into GA group (n = 30) or MAC group (n = 30). Standard monitorings were applied. In GA group, general anesthesia was carried out with propofol -sevoflurane - N2O. In MAC group, dexmedetomidine was administered for sedation and analgesia. Intraoperative vital signs, postoperative pain scores by visual analog scale (VAS) and postoperative nausea and vomiting (PONV) were compared between groups.

Results and Discussion: Intraoperatively, systolic blood pressures were significantly higher, and heart rates were lower in MAC group compared to GA group. There were no differences between groups in the patient and surgeon's satisfaction, postoperative pain scores and the incidence of PONV.

Conclusion: MAC with dexmedetomidine led to comparable satisfaction of patients and surgeons compared to general anesthesia. Incidence of postoperative adverse effects and the severity of postoperative pain were also similar between the two groups. Therefore, both anesthetic techniques can be chosen for the reduction of nasal bone fracture, based on the patients' preference and medical condition.

References:

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    2. Hytönen M, Blomgren K, Lilja M, Mäkitie AA. How we do it: septoplasties under local anaesthetic are suitable for short stay surgery - the clinical outcomes. Clin Otolaryngol 2006; 31:64-68.
    3. R Dogan, S Erbek Comparison of local anaesthesia with dexmedetomidine sedation and general anaesthesia during septoplasty Eur J Anaesthesiol 2010;27:960-4.
      © 2013 European Society of Anaesthesiology