Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 5 Issue 7

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

Mishchenko OP1, Mankov AV2* and Zabolotskii DV3

1First Ophthalmic Surgery Department, Irkutsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution, Russian Federation
2Department of Anesthesiology and Intensive Care, Irkutsk State Medical University, Russian Federation
3Department of Anesthesiology, Intensive Care and Emergency Pediatrics, Saint Petersburg State Pediatric Medical University, Russian Federation

*Corresponding Author: Mankov AV, Department of Anesthesiology and Intensive Care, Irkutsk State Medical University, Russian Federation.

Received: March 21, 2022; Published: June 08, 2022

Abstract

The analgesic effect of the pterygopalatine blockade is successfully used as anesthesia in otolaryngology, with volumetric surgical interventions in the maxillofacial region and as an interventional method for the treatment of migraine, cluster and chronic facial pain, in the treatment of post-functional pain syndrome, postherpetic neuralgia.

The purpose of this study is to evaluate the analgesic effect of the infra zygomatic access of performing a pterygopalatine block as a component of combined anesthesia during reconstructive surgery for fractures of the lower orbital edge.

Research and Design: The study was carried out at Irkutsk Branch of S. Fyodorov “Eye microsurgery” Federal State Institution of Ministry of Health of the Russian Federation. 9 male patients with the fractures of the lower orbital edge were included.

Material and Methods: Pterygopalatine blockade as a component of combined anesthesia was performed through a infrazygomatic access by the impegnation technique for pain management in reconstruction of the inferior orbital rim wall. A 25 mm needle with a 23G diameter was used to anesthetize the pterygopalatine ganglion and the maxillary nerve with solutions of local anesthetics (lidocaine 2% - 2 ml and ropivacaine 0.75% - 2 ml). The following parameters were evaluated: the adequacy of anesthesia, the duration of the analgesic effect of the pterygopalatine blockade by Verbal Rating Scale, the appointment of additional anesthesia, patient comfort, complications after the blockade.

Results: Pterygopalatine blockade as component of a combined anesthesia was effective intraoperatively and didn’t cause hemodynamic changes during surgery. During a postoperative period, patients felt comfortable without pain. No additional anesthesia required. The length of the block varied from 4 to 6 hours. Such complications as hemorrhages, intravascular injection of anesthetic, trauma of neural structures were not noticed.

Conclusion: Pterygopalatine block is a good alternative to both intra and post operative anesthesia in reposition of the inferior orbital rim wall.

Keywords: Pterygopalatine Blockade; Sphenopalatine Block; Ultrasound Navigation; Pain; Peripheral Nerve Blockade; Ophthalmic Surgery

References

  1. Harris GJ. “Avoiding complications in the repair of orbital floor fractures”. JAMA Facial Plastic Surgery 4 (2014): 290-295.
  2. Boyette JR., et al. “Management of orbital fractures: challenges and solutions”. Clinical Ophthalmology 9 (2015): 2127-2137.
  3. Shchuko AG., et al. “The role of the pterygopalatine blockade in the program of early rehabilitation of children after congenital cataract surgery”. Ophthalmology Vedomosti 4 (2017): 18-23.
  4. Chou R., et al. “Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council”. The Journal of Pain 2 (2016): 131-157.
  5. Volkov DA., et al. “The use of epidural anesthesia in coronary surgery: pros and cons”. Bulletin of Intensive Care Named After A.I. Saltanov 2 (2020): 86-95.
  6. Oleshchenko I., et al. “Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery”. Regional Anesthesia and Pain Medicine 3 (2020): 204-208.
  7. Salam GA. “Regional anesthesia for office procedures: part I. Head and neck surgeries”. American Academy of Family Physicians 69 (2004): 585-590.
  8. Degirmenci N., et al. “The Effect of Sphenopalatine Ganglion Block on the Postoperative Pain in Patients Undergoing Septorhinoplasty”. Annals of Otology, Rhinology and Laryngology 129 (7 (2020): 722-726.
  9. Mojica J., et al. “Sphenopalatine Ganglion Block in the Management of Chronic Headaches”. Current Pain and Headache Reports 6 (2017): 27.
  10. Mankov AV and Gorbachev VI. “Spinal anesthesia in surgery of lumbosacral radiculitis”. Acta Biomedica Scientifica 4 (2006): 175-180.
  11. Koryachkin VA., et al. “Anesthesiological support of fractures of the proximal femur in elderly and elderly patients”. Regional Anesthesia and Treatment of Acute Pain 11.2 (2017): 133-142.
  12. Sites BD., et al. “Artifacts and pitfall errors associated with ultrasound-guided regional anesthesia: Part II: A pictorial approach to understanding and avoidance”. Regional Anesthesia and Pain Medicine 2 (2010): 81-92.
  13. Oleshchenko IG., et al. “Ensuring the effectiveness and safety of peripheral blockades”. Acta Biomedica Scientifica6-1 (2021): 105-112.
  14. Deleuze A., et al. “Regional anesthesia for head and neck surgery”. Annales Françaises d'Anesthésie et de Réanimation 28 (2009): 818-823.

Citation

Citation: Mankov AV., et al. “Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall".Acta Scientific Orthopaedics 5.7 (2022): 21-25.

Copyright

Copyright: © 2022 Mankov AV., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US