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Regional Nerve Blocks for Middle Ear Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abdulrahman Alzmmam1, Asma Alshahrani2,3, Rena Abualjamal4
1Department of Medicine, College of Medicine and Surgery, Qassim University, Qassim, Saudi Arabia.
Summary
Superficial cervical plexus block (SCPB) and great auricular nerve block (GANB) significantly reduce pain and postoperative nausea and vomiting (PONV) after middle ear surgery. These regional nerve blocks offer improved patient recovery.
Area of Science:
- Anesthesiology and Pain Management
- Surgical Recovery
- Regional Anesthesia Techniques
Background:
- Middle ear surgery often results in significant postoperative pain, nausea, and vomiting.
- Regional nerve blocks like superficial cervical plexus block (SCPB) and great auricular nerve block (GANB) are increasingly used to manage these symptoms.
- Evaluating the efficacy of these blocks is crucial for optimizing perioperative care.
Purpose of the Study:
- To assess the effectiveness of regional nerve blocks (SCPB or GANB) in adult patients undergoing middle ear surgery.
- To compare the outcomes of nerve blocks against sham blocks or standard care.
- To analyze the impact on pain, opioid consumption, nausea, vomiting, and adverse events.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through major databases.
- Inclusion criteria focused on adult patients undergoing middle ear surgery receiving SCPB or GANB versus control.
- Key outcomes measured included pain scores, opioid use, PONV, and adverse events.
Main Results:
- Seven RCTs involving 459 participants were analyzed.
- Regional nerve blocks significantly decreased postoperative pain at 1, 12, and 24 hours (P<0.0001).
- A significant reduction in intraoperative remifentanil consumption and lower incidence of PONV were observed.
Conclusions:
- SCPB and GANB are effective adjuncts for perioperative management in middle ear surgery.
- These regional blocks enhance pain control and patient recovery.
- Further refinement of nerve block techniques is recommended for optimal patient outcomes.
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