[External dacryocystorhinostomy under local anesthesia and sedation].
BACKGROUND
External dacryocystorhinostomy (DCR) surgery is highly advantageous in that it can be performed under local anesthesia associated with sedation. We aimed at verifying the efficiency of the anesthesia, studying the general behavior of the patient and the quality of the surgery.


METHODS
A prospective study of a local anesthetic protocol associated with sedation was conducted in our Oculoplastic Department on 34 patients (71.5+/-8.3 years of age) between may 2007 and march 2008. The anesthetic protocol consisted of blocking four nerves based on the analysis of the anatomy of facial innervation. The including criteria were patient antecedents such as arterial hypertension, cardiac or lung problems, diabetes, and no contraindications for local anesthesia. The hemodynamic constants, variability of the Ramsay score, and complications such as bleeding or pain were studied. The progress of the surgery was simultaneously evaluated by the patients, anesthesiologists, and surgeons.


RESULTS
Both the hemodynamic constants and the Ramsay score remained stable intra- and postoperatively. In addition, the visual analog scale (VAS) scores remained low. Both surgeon and patient satisfaction was excellent (88.4 % of the patients declared that they were ready to choose the same anesthetic protocol if new surgery were to be performed). The surgery's success rate was 79.3 % (no watering at 3 months) versus 82 % for the patients operated under general anesthesia.


CONCLUSIONS
The protocol of local anesthesia associated with sedation for external DCR is therefore safe and efficient.
Chaume
A
A
Service d'ophtalmologie, Centre Hospitalo-Universitaire de Nancy Brabois, Vandoeuvre-lès-Nancy, France.
Maalouf
T
T
Thirion
B
B
Angioi
K
K
George
J-L
JL
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D016292:Procedural Sedation / Q000379:methods* / Q000523:psychology; D003608:Dacryocystorhinostomy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000150:complications / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods* / Q000523:psychology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D017060:Patient Satisfaction; D018579:Patient Selection; D011446:Prospective Studies; D012449:Safety; D018709:Statistics, Nonparametric; D016896:Treatment Outcome