The Journal of craniofacial surgery
-
Randomized Controlled Trial
Analgesic effects of preoperative peripheral nerve block in patients with trigeminal neuralgia undergoing radiofrequency thermocoagulation of gasserian ganglion.
Trigeminal neuralgia is the worst pain that human beings have ever experienced. Surgery might be the only solution for some patients because no other way can relieve their severe pain. They experience intolerable pain before operation and during radiofrequency thermocoagulation of the gasserian ganglion. ⋯ Compared with the control group, a single peripheral nerve block significantly attenuated average pain (P < 0.01) and worst pain (P < 0.01), ameliorated the quality of sleep (P < 0.01), and increased analgesia satisfaction (P < 0.01). Moreover, patients in the nerve block group experienced a decrease in incidence (P < 0.01) and intensity (P < 0.01) of episodic pain during surgery as compared with the participants in the control group. These results demonstrate that a single peripheral nerve block may be an effective way to relieve preoperative and perioperative intolerable pain of trigeminal neuralgia.
-
The aim of this study is to follow longitudinally the prominent ears treated by percutaneous adjustable closed otoplasty (PACO) and evaluate this procedure in terms of technical efficiency, recurrence, complications, and patient satisfaction. ⋯ Percutaneous adjustable closed otoplasty is an efficient surgical procedure with positive outcome, low recurrence, and high patient satisfaction. In prominent ear deformities with soft cartilage, PACO should be the preferred surgical choice because of its advantages of shorter time in surgery, lack of need for prolonged postoperative compressive dressing, and allowing patients to view the results immediately after surgery. In contrast to the previously described techniques, auriculocephalic distances are adjustable while tightening the mattress sutures. Besides, it is a reversible technique, if the surgeon not satisfied with the result of the surgery can either redo the procedure or revert to CST. Percutaneous adjustable closed otoplasty does not cause serious complications, contour deformities, hematoma, or incision scars. For ear deformities presenting with stiff helical cartilage and conchal hyperthrophy, surgical indications can be extended by scoring and conchal resection, respectively.
-
Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. The most common predisposing risk factor for mucormycosis is diabetes mellitus. ⋯ Diabetic ketoacidosis is the most common and serious acute complication of diabetic patients. We herein report 2 cases of fatal rhino-orbito-cerebral mucormycosis in a patient with diabetic ketoacidosis.
-
Case Reports
Transdermal scopolamine and perioperative anisocoria in craniofacial surgery: a report of 3 patients.
Postoperative nausea and vomiting (PONV) is a common complaint after plastic and reconstructive surgery. Transdermal scopolamine is a commonly used agent for prevention of PONV. ⋯ Given the various causes and potentially grave implications of unilateral mydriasis, we discourage the use of transdermal scopolamine in craniofacial surgery, and especially in orbital surgery. However, if transdermal scopolamine is decided to be used for PONV prophylaxis, we recommend educating the patient, the operating room staff, and the surgical team regarding this potential adverse effect and to avoid finger-to-eye contamination after patch manipulation.
-
Randomized Controlled Trial
Efficacy of a single preoperative dose of pregabalin for postoperative pain after septoplasty.
We aimed to investigate the role of preoperative single dose of pregabalin for attenuating postoperative pain and analgesic consumption in patients undergoing septoplasty. One hundred forty-three patients with ASA physical status I who underwent elective septoplasty were included in this prospective, randomized, and controlled study. Subjects were randomized to receive pregabalin 75 mg, pregabalin 150 mg, and control group. ⋯ Visual analog scale scores in the 1st, 2nd, 4th, 6th, 12th, and 24th hour were significantly decreased in 75 and 150 mg pregabalin group compared with the control group, and VAS scores in the 12th and 24th hour were significantly decreased in pregabalin 150 mg compared with 75 mg. The 24th total analgesic consumption was significantly decreased in pregabalin 75 mg and 150 mg groups compared with the control group. In conclusion, a single preoperative oral dose pregabalin 75 or 150 mg is an effective method for reducing postoperative pain and total analgesic consumption in patients undergoing septoplasty.