Role of local anaesthetic nerve block in endoscopic sinus surgery: A systematic review and meta‐analysis
Objective The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS). Design The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the...
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| Veröffentlicht in: | Clinical otolaryngology 2018-10, Vol.43 (5), p.1201-1208 |
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| container_title | Clinical otolaryngology |
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| creator | Shamil, E. Rouhani, M.J. Basetti, S. Bast, F. Hopkins, C. Surda, P. |
| description | Objective
The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS).
Design
The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the Ovid portal (1946‐2017).
Results
Seven randomised controlled trials were included. Due to considerable heterogeneity of data, only two studies were pooled into meta‐analysis which demonstrated a statistically significantly better surgical field quality during ESS in the LAB group compared with the control group (MD −0.86; 95% CI −2.24, 0.51; P = .009). No adverse events related to LAB toxicity were reported.
Conclusions
Sphenopalatine ganglion LAB with adrenaline carries relatively low risk of morbidity, but may improve the quality of the surgical field in terms of bleeding. However, there are limitations of the study due to heterogeneity of methods, quality and size of the studies. Well‐conducted large RCTs are needed using standardised inclusion criteria, balanced baseline characteristics of cohorts, and validated subjective and objective outcome measures. |
| doi_str_mv | 10.1111/coa.13128 |
| format | Article |
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The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS).
Design
The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the Ovid portal (1946‐2017).
Results
Seven randomised controlled trials were included. Due to considerable heterogeneity of data, only two studies were pooled into meta‐analysis which demonstrated a statistically significantly better surgical field quality during ESS in the LAB group compared with the control group (MD −0.86; 95% CI −2.24, 0.51; P = .009). No adverse events related to LAB toxicity were reported.
Conclusions
Sphenopalatine ganglion LAB with adrenaline carries relatively low risk of morbidity, but may improve the quality of the surgical field in terms of bleeding. However, there are limitations of the study due to heterogeneity of methods, quality and size of the studies. Well‐conducted large RCTs are needed using standardised inclusion criteria, balanced baseline characteristics of cohorts, and validated subjective and objective outcome measures.</description><identifier>ISSN: 1749-4478</identifier><identifier>EISSN: 1749-4486</identifier><identifier>DOI: 10.1111/coa.13128</identifier><identifier>PMID: 29706016</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>anaesthetic ; Anesthesia ; Anesthetics, Local - therapeutic use ; Bleeding ; block ; endoscopic ; Endoscopy ; Heterogeneity ; Humans ; local ; Local anesthesia ; Meta-analysis ; Morbidity ; Nerve Block ; Rhinitis - surgery ; sinus ; Sinusitis - surgery ; Surgery ; Systematic review ; Toxicity</subject><ispartof>Clinical otolaryngology, 2018-10, Vol.43 (5), p.1201-1208</ispartof><rights>2018 John Wiley & Sons Ltd</rights><rights>2018 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-4f99610844f22901872fc2aa9d0e7aadbd571f728529ae677ad1764036df3ae53</citedby><cites>FETCH-LOGICAL-c3538-4f99610844f22901872fc2aa9d0e7aadbd571f728529ae677ad1764036df3ae53</cites><orcidid>0000-0002-5599-9953 ; 0000-0002-0920-7927</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcoa.13128$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcoa.13128$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29706016$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shamil, E.</creatorcontrib><creatorcontrib>Rouhani, M.J.</creatorcontrib><creatorcontrib>Basetti, S.</creatorcontrib><creatorcontrib>Bast, F.</creatorcontrib><creatorcontrib>Hopkins, C.</creatorcontrib><creatorcontrib>Surda, P.</creatorcontrib><title>Role of local anaesthetic nerve block in endoscopic sinus surgery: A systematic review and meta‐analysis</title><title>Clinical otolaryngology</title><addtitle>Clin Otolaryngol</addtitle><description>Objective
The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS).
Design
The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the Ovid portal (1946‐2017).
Results
Seven randomised controlled trials were included. Due to considerable heterogeneity of data, only two studies were pooled into meta‐analysis which demonstrated a statistically significantly better surgical field quality during ESS in the LAB group compared with the control group (MD −0.86; 95% CI −2.24, 0.51; P = .009). No adverse events related to LAB toxicity were reported.
Conclusions
Sphenopalatine ganglion LAB with adrenaline carries relatively low risk of morbidity, but may improve the quality of the surgical field in terms of bleeding. However, there are limitations of the study due to heterogeneity of methods, quality and size of the studies. Well‐conducted large RCTs are needed using standardised inclusion criteria, balanced baseline characteristics of cohorts, and validated subjective and objective outcome measures.</description><subject>anaesthetic</subject><subject>Anesthesia</subject><subject>Anesthetics, Local - therapeutic use</subject><subject>Bleeding</subject><subject>block</subject><subject>endoscopic</subject><subject>Endoscopy</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>local</subject><subject>Local anesthesia</subject><subject>Meta-analysis</subject><subject>Morbidity</subject><subject>Nerve Block</subject><subject>Rhinitis - surgery</subject><subject>sinus</subject><subject>Sinusitis - surgery</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Toxicity</subject><issn>1749-4478</issn><issn>1749-4486</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtOwzAURS0EoqUwYAPIEiMGaf1LnDCrKn5SJSQEY8tNXiAliYudtMqMJbBGVoJLSme8iZ90j4_si9A5JWPqZ5IaPaacsvgADakUSSBEHB3udxkP0IlzS0IEJ5IeowFLJIkIjYZo-WRKwCbHpUl1iXWtwTVv0BQprsGuAS988I6LGkOdGZealU9cUbcOu9a-gu2u8RS7zjVQ6e0tC-sCNl6U4Qoa_f355Z1l5wp3io5yXTo4250j9HJ78zy7D-aPdw-z6TxIecjjQORJElESC5EzlhAaS5anTOskIyC1zhZZKGkuWRyyREMkpc6ojAThUZZzDSEfocveu7Lmo_XfUUvTWv8IpxglXEZhwomnrnoqtcY5C7la2aLStlOUqG2ryreqflv17MXO2C4qyPbkX40emPTApiih-9-kZo_TXvkDhOWCEw</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Shamil, E.</creator><creator>Rouhani, M.J.</creator><creator>Basetti, S.</creator><creator>Bast, F.</creator><creator>Hopkins, C.</creator><creator>Surda, P.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0002-5599-9953</orcidid><orcidid>https://orcid.org/0000-0002-0920-7927</orcidid></search><sort><creationdate>201810</creationdate><title>Role of local anaesthetic nerve block in endoscopic sinus surgery: A systematic review and meta‐analysis</title><author>Shamil, E. ; Rouhani, M.J. ; Basetti, S. ; Bast, F. ; Hopkins, C. ; Surda, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-4f99610844f22901872fc2aa9d0e7aadbd571f728529ae677ad1764036df3ae53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>anaesthetic</topic><topic>Anesthesia</topic><topic>Anesthetics, Local - therapeutic use</topic><topic>Bleeding</topic><topic>block</topic><topic>endoscopic</topic><topic>Endoscopy</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>local</topic><topic>Local anesthesia</topic><topic>Meta-analysis</topic><topic>Morbidity</topic><topic>Nerve Block</topic><topic>Rhinitis - surgery</topic><topic>sinus</topic><topic>Sinusitis - surgery</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shamil, E.</creatorcontrib><creatorcontrib>Rouhani, M.J.</creatorcontrib><creatorcontrib>Basetti, S.</creatorcontrib><creatorcontrib>Bast, F.</creatorcontrib><creatorcontrib>Hopkins, C.</creatorcontrib><creatorcontrib>Surda, P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Clinical otolaryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shamil, E.</au><au>Rouhani, M.J.</au><au>Basetti, S.</au><au>Bast, F.</au><au>Hopkins, C.</au><au>Surda, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of local anaesthetic nerve block in endoscopic sinus surgery: A systematic review and meta‐analysis</atitle><jtitle>Clinical otolaryngology</jtitle><addtitle>Clin Otolaryngol</addtitle><date>2018-10</date><risdate>2018</risdate><volume>43</volume><issue>5</issue><spage>1201</spage><epage>1208</epage><pages>1201-1208</pages><issn>1749-4478</issn><eissn>1749-4486</eissn><abstract>Objective
The aim of the study was to perform a systematic review of existing evidence on the role of local anaesthetic nerve block (LAB) in patients undergoing endoscopic sinus surgery (ESS).
Design
The databases searched were the Cochrane Register of Controlled Trials, MEDLINE and Embase using the Ovid portal (1946‐2017).
Results
Seven randomised controlled trials were included. Due to considerable heterogeneity of data, only two studies were pooled into meta‐analysis which demonstrated a statistically significantly better surgical field quality during ESS in the LAB group compared with the control group (MD −0.86; 95% CI −2.24, 0.51; P = .009). No adverse events related to LAB toxicity were reported.
Conclusions
Sphenopalatine ganglion LAB with adrenaline carries relatively low risk of morbidity, but may improve the quality of the surgical field in terms of bleeding. However, there are limitations of the study due to heterogeneity of methods, quality and size of the studies. Well‐conducted large RCTs are needed using standardised inclusion criteria, balanced baseline characteristics of cohorts, and validated subjective and objective outcome measures.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29706016</pmid><doi>10.1111/coa.13128</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5599-9953</orcidid><orcidid>https://orcid.org/0000-0002-0920-7927</orcidid></addata></record> |
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| ispartof | Clinical otolaryngology, 2018-10, Vol.43 (5), p.1201-1208 |
| issn | 1749-4478 1749-4486 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | anaesthetic Anesthesia Anesthetics, Local - therapeutic use Bleeding block endoscopic Endoscopy Heterogeneity Humans local Local anesthesia Meta-analysis Morbidity Nerve Block Rhinitis - surgery sinus Sinusitis - surgery Surgery Systematic review Toxicity |
| title | Role of local anaesthetic nerve block in endoscopic sinus surgery: A systematic review and meta‐analysis |
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