A prospective study of multimodal cocktail intercostal injection for chest pain relief after costal cartilage harvest for rhinoplasty |
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| Institution: | 1. Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany;2. Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait;3. Faculty of Mechanical and Energy Engineering, University of Applied Sciences (HTWK), Karl- Liebknecht Str. 145, 04277 Leipzig, Germany;4. Department of Ophthalmology, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany;1. Department of Internal Medicine, Limoges University Hospital Center, Limoges, France;2. Department of Ophthalmology, Limoges University Hospital Center, Limoges, France;1. GSR Hospital, Hyderabad, Telangana, India;2. Department of Otorhinolaryngology, Head & Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands;3. Sri Sai College of Dental Surgery, Department of Oral and Maxillofacial Surgery, Vikarabad, Telangana, India;4. Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands;5. Dept. Of Cranio-maxillofacial Surgery, AIIMS, Rishikesh, Uttarakhand, India;1. Department of Plastic Surgery, St Thomas’ Hospital, London, United Kingdom;2. Department of Oral and Maxillofacial Surgery, The Queen Victoria Hospital, East Grinstead, United Kingdom;3. Foundation Year 1 Doctor, Department of General Surgery, University Hospital of North Tees Newcastle, United Kingdom;4. Honorary Professor of Surgery, Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom |
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| Abstract: | Our aim was to evaluate the efficacy and safety of multimodal cocktail intercostal injection for the relief of chest pain after costal cartilage harvest for rhinoplasty. Consecutive patients who underwent costal cartilage harvest during rhinoplasty were prospectively assigned as per patient preference to group A (injection containing ropivacaine, parecoxib sodium, epinephrine, and compound betamethasone), group B (intercostal nerve block (ICNB)), or group C (ICNB plus patient-controlled analgesia (PCA)). The outcomes were visual analogue scale (VAS) scores for chest pain after costal cartilage harvest, rescue analgesia, complications, and cost during the first two days. Of the 66 patients assessed, 63 (29 patients in group A, 13 in group B, and 21 in group C) were eligible and included. The VAS scores in group A were significantly lower than those in groups B and C (all p<0.001). Group A had a significantly lower rate of rescue analgesia due to a VAS score of more than 4 (3.45%, 1/29) compared with group B (46.15%, 6/13; p=0.001) and group C (28.57%, 6/21; p=0.012). Complications were observed only in group C (nausea/vomiting 28.57%; dizziness/headache 23.81%), which differed significantly from group A (p=0.002 and 0.006, respectively). The mean cost for group A (US $15 (0)) was significantly lower than it was for group C (US $113.1 (4.4), p<0.05), but higher than it was for group B (US $5.97 (0), p= -). Multimodal cocktail intercostal injection may be superior for chest pain relief after costal cartilage harvest for rhinoplasty compared with ICNB with or without PCA. Further study is warranted. |
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| Keywords: | multimodal cocktail intercostal nerve block costal cartilage rhinoplasty |
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