J Korean Soc Plast Reconstr Surg.  2006 Jul;33(4):445-448.

Adequacy of Local Anesthesia on the Anterior Ethmoidal Nerve and the Dorsal Periosteum for the Reduction of the Fractured Nasal Bones

• Cho JH
• Lee HK
• Rah DK
• Tark KC

Abstract

PURPOSE
The nose is the most prominent skeletal feature of the face and is thus prone to frequent injury. Closed reduction of nasal bone fractures can be performed under general or local anesthesia. However, the benefits and the drawbacks in either form of anesthesia chosen are seldom perceived by the surgeon. A retrospective study was performed to assess the differences in the outcome among the two groups subjected to surgery under different type of anesthesia and to introduce our method of local anesthesia and its adequacy.
METHODS
Two hundred and fifteen patients during a 2-year period were included in the study. 2% Lidocaine mixed with 1:100,000 epinephrine was injected on the anterior ethmoid nerve and the periosteum. Assessment factors included intra-operative adequacy of analgesia, post-operative analgesic requirement and functional and aesthetic outcome of surgery.
RESULTS
19 patients were manipulated under general anesthesia and 196 patients were manipulated under local anesthesia on the anterior ethmoidal nerve and dorsal periosteum. No statistically signigicant variable in performance of surgery could be attributed to the mode of anesthesia employed(p>0.05). Four patients experienced complications after reduction. One developed septal deviation and three nasal obstruction. But, no secondary operations were needed.
CONCLUSION
Anterior ethmoidal nerve block and dorsal periosteal injection of 2% Xylocaine, combined with topical intranasal 4% lidocaine and epinephrine provided sufficient analgesia comparable to that of general anesthesia.

Keyword

Nasal bone reduction; Adequacy of local infiltration

MeSH Terms

Analgesia
Anesthesia
Anesthesia, General
Anesthesia, Local*
Epinephrine
Humans
Lidocaine
Nasal Bone*
Nasal Obstruction
Nerve Block
Nose
Periosteum*
Retrospective Studies
Epinephrine
Lidocaine