Laser-uvulopalatoplasty (LUPP) under local anesthesia: effective, safe and comfortable

Conventional uvulopalatopharyngoplasty has in the last years to an increasing extent been succeeded by a variety of laser procedures for snorers obstructed by lax palates only. These surgical techniques have the advantages of being less traumatic and therefore more suitable for local anesthesia and outpatient surgery. However, to the authors' knowledge, there are no studies on degree of patient discomfort during this type of surgery as well as the value of anticholinergic component in premedication in preventing bradycardia and hypersalivation during the operation. We studied 53 consecutive patients undergoing laser-uvulopalatoplasty (LUPP) under local anesthesia at our day care unit. LUPP is a one-stage operation for rhonchopathy which has been developed at our department. Twenty-five patients received morphine and scopolamine, and 28 morphine alone as premedication. Peroperative salivation, bradycardia and nausea was estimated and recorded for each group. Later the patients were asked to assess mouth dryness both before and after surgery, as well as satisfaction with sedation and pain relief. The great majority of the patients (> 80%) described only insignificant pain, which when occurring was related to subliminal premedication or to the injection of local anesthesia or both. Morphine-scopolamine was significantly better in preventing hypersalivation (p < 0.01) during surgery and also improved sedation and analgesia when compared to morphine alone (p < 0.05). The efficacy of LUPP is compared with various laser procedures for snoring.