Assisted local anaesthesia for endoscopic dacryocystorhinostomy.
BACKGROUND
Endoscopic dacryocystorhinostomy is traditionally performed under general anaesthesia. However, there are reports in the literature of various local anaesthetic techniques with or without sedation for this procedure. An effective and acceptable local anaesthetic technique enables the avoidance of the risks associated with general anaesthesia, particularly for elderly patients, with the added benefit of reduced bleeding, reduced nausea and vomiting, and reduced length of hospital stay and thus health care cost savings. This study aims to evaluate the safety and patient acceptance of a minimally invasive assisted local anaesthetic technique for endoscopic dacryocystorhinostomy.


METHODS
A prospective questionnaire-based study is presented of 24 consecutive adult patients who underwent 26 endoscopic dacryocystorhinostomies in a day surgery including 22 primary and four revision procedures performed by one surgeon under local anaesthesia and sedation over a 4-month period.


RESULTS
Apart from persistent postoperative vomiting in one patient there were no anaesthetic complications. There were no instances of epistaxis. The mean pain score on a visual analogue scale of 0-10 was 1.56 and 56% reported no pain. Ninety-two per cent would recommend the procedure to others.


CONCLUSIONS
This assisted local anaesthetic technique for endoscopic dacryocystorhinostomy is safe and acceptable to patients.
Howden
Juliette
J
Sydney Oculoplastic Surgery, Department of Ophthalmology, Royal Prince Alfred Hospital, Camperdown, and University of New South Wales, Liverpool, Australia.
McCluskey
Peter
P
O'Sullivan
Greg
G
Ghabrial
Raf
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016292:Procedural Sedation; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D017060:Patient Satisfaction; D010656:Phenylephrine / Q000008:administration & dosage; D011430:Propoxycaine / Q000008:administration & dosage; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D000779:Anesthetics, Local; D010656:Phenylephrine; D008012:Lidocaine; C005717:proxymetacaine; D011430:Propoxycaine