Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy
Objective: To assess the tolerability and efficacy of endoscopic sphenopalatine artery cauterization (ESPAC) under local anesthesia (LA) in managing posterior epistaxis. Methods: It was a prospective, cohort study, conducted in the Otorhinolaryngology Department of a tertiary-level hospital. Patien...
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| Format: | Article |
| Language: | English |
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Galenos Yayincilik
2024-09-01
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| Series: | Turkish Archives of Otorhinolaryngology |
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| Online Access: | https://www.turkarchotolaryngol.net/articles/endoscopic-sphenopalatine-artery-cauterization-under-local-anesthesia-for-posterior-epistaxis-a-prospective-cohort-study-of-its-tolerability-and-efficacy/doi/tao.2024.2024-5-2 |
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| author | Urmila Gurung Narmaya Thapa Sajish Khadgi |
| author_facet | Urmila Gurung Narmaya Thapa Sajish Khadgi |
| author_sort | Urmila Gurung |
| collection | DOAJ |
| description | Objective: To assess the tolerability and efficacy of endoscopic sphenopalatine artery cauterization (ESPAC) under local anesthesia (LA) in managing posterior epistaxis.
Methods: It was a prospective, cohort study, conducted in the Otorhinolaryngology Department of a tertiary-level hospital. Patients aged 18 years or above with posterior epistaxis who underwent ESPAC under LA were included. The tolerability of the procedure was reflected by the intraoperative pain measured using an 11-point numerical rating scale while the rebleed rate up to three months postoperatively denoted its efficacy.
Results: A total of 35 patients, 23 males and 12 females, aged 31 to 86 years (mean 57.42 ± 12.94) were included. Five out of 35 (14.2%) patients needed additional procedures besides ESPAC; 82.8% (29/35) had pterygopalatine fossa (PPF) block before ESPAC. The numerical rating scale reflecting the intraoperative pain ranged from 1 to 7 with a mean of 3.6 (± 1.7). The mean score was slightly higher in females than in males. Similarly, those who did not receive PPF block had a higher mean score than those who received it; however, the differences were not statistically significant. Meanwhile, the mean score was the same (3.6) irrespective of any additional procedure besides ESPAC. Amongst the 30 patients who completed the three-month follow-up, two patients rebled, so the overall success rate amounted to 93.3% in three months.
Conclusion: Based on the outcome of this study, ESPAC under LA for posterior epistaxis is well tolerated and is as efficacious as under general anesthesia. |
| format | Article |
| id | doaj-art-71c8927ff9f843539ec1401a1eaa5612 |
| institution | Kabale University |
| issn | 2667-7474 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Galenos Yayincilik |
| record_format | Article |
| series | Turkish Archives of Otorhinolaryngology |
| spelling | doaj-art-71c8927ff9f843539ec1401a1eaa56122025-01-14T08:28:17ZengGalenos YayincilikTurkish Archives of Otorhinolaryngology2667-74742024-09-01623889410.4274/tao.2024.2024-5-2Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and EfficacyUrmila Gurung0https://orcid.org/0000-0001-7640-0199Narmaya Thapa1https://orcid.org/0000-0002-2634-8430Sajish Khadgi2https://orcid.org/0000-0003-0348-5472Tribhuvan University Teaching Hospital Institute of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kathmandu, NepalTribhuvan University Teaching Hospital Institute of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kathmandu, NepalTribhuvan University Teaching Hospital Institute of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Kathmandu, NepalObjective: To assess the tolerability and efficacy of endoscopic sphenopalatine artery cauterization (ESPAC) under local anesthesia (LA) in managing posterior epistaxis. Methods: It was a prospective, cohort study, conducted in the Otorhinolaryngology Department of a tertiary-level hospital. Patients aged 18 years or above with posterior epistaxis who underwent ESPAC under LA were included. The tolerability of the procedure was reflected by the intraoperative pain measured using an 11-point numerical rating scale while the rebleed rate up to three months postoperatively denoted its efficacy. Results: A total of 35 patients, 23 males and 12 females, aged 31 to 86 years (mean 57.42 ± 12.94) were included. Five out of 35 (14.2%) patients needed additional procedures besides ESPAC; 82.8% (29/35) had pterygopalatine fossa (PPF) block before ESPAC. The numerical rating scale reflecting the intraoperative pain ranged from 1 to 7 with a mean of 3.6 (± 1.7). The mean score was slightly higher in females than in males. Similarly, those who did not receive PPF block had a higher mean score than those who received it; however, the differences were not statistically significant. Meanwhile, the mean score was the same (3.6) irrespective of any additional procedure besides ESPAC. Amongst the 30 patients who completed the three-month follow-up, two patients rebled, so the overall success rate amounted to 93.3% in three months. Conclusion: Based on the outcome of this study, ESPAC under LA for posterior epistaxis is well tolerated and is as efficacious as under general anesthesia.https://www.turkarchotolaryngol.net/articles/endoscopic-sphenopalatine-artery-cauterization-under-local-anesthesia-for-posterior-epistaxis-a-prospective-cohort-study-of-its-tolerability-and-efficacy/doi/tao.2024.2024-5-2epistaxisendoscopic surgical procedurelocal anesthesiapterygopalatine fossacauterypain |
| spellingShingle | Urmila Gurung Narmaya Thapa Sajish Khadgi Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy Turkish Archives of Otorhinolaryngology epistaxis endoscopic surgical procedure local anesthesia pterygopalatine fossa cautery pain |
| title | Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy |
| title_full | Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy |
| title_fullStr | Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy |
| title_full_unstemmed | Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy |
| title_short | Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy |
| title_sort | endoscopic sphenopalatine artery cauterization under local anesthesia for posterior epistaxis a prospective cohort study of its tolerability and efficacy |
| topic | epistaxis endoscopic surgical procedure local anesthesia pterygopalatine fossa cautery pain |
| url | https://www.turkarchotolaryngol.net/articles/endoscopic-sphenopalatine-artery-cauterization-under-local-anesthesia-for-posterior-epistaxis-a-prospective-cohort-study-of-its-tolerability-and-efficacy/doi/tao.2024.2024-5-2 |
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