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Emergence agitation following general anaesthesia may lead to serious complications like self-extubation or removal of catheters, which can lead to hypoxia, aspiration pneumonia, bleeding or reoperation. Nose surgery is associated with a higher incidence of emergence agitation. The investigators planned to evaluate the efficacy of external nasal nerve block in prevention of postoperative agitation following external nasal surgeries under general anesthesia(GA).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I(control) | Placebo Comparator | patients allocated for external nasal nerve block with saline adrenaline 1/200,000 (placebo) |
|
| Group II(block) | Active Comparator | 'External nasal nerve block by Xylocaine, adrenaline' |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| External nasal nerve block | Procedure | Three single (midline injection) and 4 paired (bilateral injection) sites to block the external nasal sensation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| postoperative agitation | Assessment done using Richmond agitation- sedation scale (RASS) | Emergence is defined as the time interval from discontinuation of anesthesia to 5 min after extubation. |
| Quality of recovery | Quality of recovery | 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| dose of fentanyl | Fentanyl boluses were given in response to changes in hemodynamics (more than 15% increases in MAP and HR than the baseline values taken after induction by 5 minutes) | intraoperative period in minutes |
| morphine dose in PACU |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Al Jedaani group of hospitals | Jeddah | Meccah | 21462/7500 | Saudi Arabia |
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| ID | Term |
|---|---|
| D008012 | Lidocaine |
| D004837 | Epinephrine |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 |
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| saline adrenaline | Drug |
|
| Xylocaine, adrenaline | Drug |
|
equivalent morphine dose in PACU (calculated using opioid:morphine equivalents of 100 µg i.v. fentanyl to 10 mg i.v. morphine; 75- 100 mg IV pethidine to 10 mg i.v. morphine
| one hour in PACU |
| Nausea and vomiting in PACU | Four-point nausea and vomiting scale (0=no nausea; 1=mild nausea; 2=severe nausea requiring antiemetics; and 3=retching, vomiting, or both) was also evaluated | one hour in PACU |
| Extubation time | Up to 15 after discontinuation of anesthesia |
| Surgical time | intraoperative | duration of surgery in minutes up to 3 hours |
| first verbal response time | period from discontinuation of anesthesia 'time zero' to 1st verbal response in minutes | up to 15 minutes |
| complication of nasal block | including local anesthetic systemic toxicity, vascular injury, intravascular injection of local anesthetic, and local hematoma. | From injection to 24 hours postoperative |
| Aniline Compounds |
| D000588 | Amines |
| D004983 | Ethanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D015306 | Biogenic Monoamines |
| D001679 | Biogenic Amines |
| D002395 | Catecholamines |
| D002396 | Catechols |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |