title: Topical levobupivacaine efficacy in pain control after functional endoscopic sinus surgery.
abstract: OBJECTIVE
  The aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel Kennedy; Medtronic Xomed, Jacksonville, Florida) sinus pack soaked with levobupivacaine hydrochloride to control postoperative pain and analgesic need following functional endoscopic sinus surgery (FESS).
  
  
  METHODS
  The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent FESS were included in the analysis. Setting A tertiary referral hospital in Turkey.
  
  
  METHODS
  Patients who underwent FESS were divided into 2 groups. The PVA sponge sinus packs were soaked with 5 mL of levobupivacaine hydrochloride (chirocaine 25 mg/10 mL; Abbott, Nycomed Pharma AS, Elverum, Norway) in group I and with 5 mL of saline in group II.
  
  
  METHODS
  Postoperative pain levels were recorded using a visual analog scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours.
  
  
  RESULTS
  There were no statistically significant differences between groups regarding age, sex, and American Society of Anesthesiologists status. Postoperative VAS values at 30 minutes and 1, 2, 8, 12, and 24 hours were significantly lower in group I than in group II (P < .05). Supplemental analgesia amount was significantly lower in group I than in group II (P = .003).
  
  
  CONCLUSIONS
  Using levobupivacaine-soaked PVA sponge sinus packs after FESS is an effective, easy, and quick method to control postoperative pain, and it improves patient comfort and tolerability.
authors.affiliation: Düzce Medical Faculty ENT Department, Düzce, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Sahnur
authors.initials: S
authors.lastname: Yildizbas
authors.forename: Ender
authors.initials: E
authors.lastname: Güçlü
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Yaman
authors.forename: Gülbin
authors.initials: G
authors.lastname: Yalçin Sezen
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: endoscopic sinus surgery; levobupivacaine; pain management; topical anesthetic application