Nasal fractures: a study comparing local and general anaesthesia techniques

The objective of the present study was to examine the outcome of nasal fracture reduction under both local anaesthesia and general anaesthesia techniques.

Patient records were obtained from clinic lists of patients attending the otolaryngology (ORL) outpatient unit at Wellington Hospital or the plastic surgical unit at Hutt Hospital over a 24-month period. To meet criteria for inclusion, patients had to have an isolated nasal deformity, be aged 14 years or older and be at least 6 months post reduction. Functional and aesthetic results were assessed using subjective and objective end outcome measures. A questionnaire was developed and used to assess subjective outcomes. The number of patients proceeding to open operative correction was used for the objective measure, which included septoplasty, septorhinoplasty or rhinoplasty.

A total of 197 patients had nasal fractures manipulated over this period. One hundred and seven were manipulated under general anaesthesia (GA) and 90 were manipulated under local anaesthesia (LA). The questionnaire completion rate was 66%. Patient demographics were statistically similar between the two groups. There was no statistical difference in patients" subjective assessment of outcome with treatment by GA or LA. More patients preferred to have their fracture manipulated under GA but this was not statistically significant. There was no significant difference between GA and LA groups in progression to open operative correction.

Both LA and GA appear to be acceptable and satisfactory methods of anaesthesia in the reduction of simple displaced nasal fracture.