Nasal fracture reduction: local versus general anaesthesia.
OBJECTIVE
To investigate the outcomes from nasal fracture reduction performed under local anaesthesia (LA) and general anaesthesia (GA).


METHODS
A randomised multi-centred prospective trial and cohort analysis. Patients were randomised into two groups, 74 (53%) underwent closed reduction under LA, 65 (47%) patients underwent closed reduction under GA.


METHODS
Pain scores and patient toleration of local or general nasal manipulation was noted.


RESULTS
The pain score ranged from 0 (no pain) to 10 (unbearable pain). The mean pain score in the LA group was 3, compared to 2 in the GA group. LA manipulation was tolerated equally well as GA manipulation by 85% of the patients in each group. The number of patients requiring a septorhinoplasty was compared between LA 19/74 (26%), and GA 21/65 (32%). This failed to demonstrate a significant difference with a p value of 0.50. The absolute risk difference was 5% with a 95% confidence interval of (20% to -10%).


CONCLUSIONS
This trial clearly shows LA to be as effective as GA in the first line management of nasal fractures. The degree of septal displacement and presence of nasal tip deviation were associated with persistent nasal deformity following nasal fracture reduction.
Khwaja
S
S
Department of Otolaryngology, Manchester Royal Infirmary, Manchester, United Kingdom. sadiekhwaja@hotmail.com
Pahade
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AV
Luff
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Green
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Green
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KM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008349:Manipulation, Orthopedic; D008875:Middle Aged; D009295:Nasal Bone / Q000293:injuries*; D015508:Nasal Obstruction / Q000209:etiology; D009300:Nasal Septum / Q000473:pathology; D009666:Nose / Q000473:pathology; D009667:Nose Deformities, Acquired / Q000209:etiology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D012887:Skull Fractures / Q000628:therapy*
D000779:Anesthetics, Local; D008012:Lidocaine