Author(s)
Shahzeb Hasan, BS
Delaney Carpenter, MD
Rebecca Pierce, BS
Victoria Dailo, BS
Jose Mattos, MD
Spencer Payne, MD
Affiliation(s)
University of Virginia;
Abstract:
Educational Objective: At the conclusion of this presentation, participants should be able to describe the postoperative pain and PACU length of stay effects of intraoperative analgesic injection in FESS.
Objectives: The objective of this study was to determine whether an intraoperative submucosal injection of local anesthetic impacts postoperative pain scores and narcotics use in the postoperative care unit among patients undergoing functional endoscopic sinus surgery (FESS).
Study Design: Retrospective chart review.
Methods: A chart review was performed of patients who underwent FESS between October 2019 and May 2022. Inclusion criteria included patients with a diagnosis of chronic rhinosinusitis with or without polyps and those who underwent at least bilateral maxillary antrostomy and total ethmoidectomy, with or without sphenoidotomy, frontal sinus exploration, septoplasty, or inferior turbinate reduction. Exclusion criteria included a history of chronic pain with routine use of narcotics. Postoperative pain scores and intraoperative/postoperative narcotics use as measured by morphine milligram equivalents (MME) were compared between patients who underwent intraoperative lidocaine injection and those who did not using a student's T test.
Results: Data from 83 FESS patients were examined, 40 of whom underwent local anesthetic injection intraoperatively at the start of the case. There was no statically significant difference in postoperative pain scores, MME, or length of surgery. There was a significant difference in PACU length of stay. When excluding patients who underwent septoplasty, there was no statically significant difference in postoperative pain scores, MME, or length of surgery. There was a significant difference in PACU length of stay.
Conclusions: This study failed to demonstrate a statistically significant effect on postoperative pain scores after intraoperative local anesthetic injection, however, this analgesic modality has the potential to reduce PACU length of stay.