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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Analgesia, Endoscopy, Female, Fentanyl, Humans, Length of Stay, Male, Middle Aged, Nausea, Paranasal Sinuses, Postoperative Care, Postoperative Nausea and Vomiting, Sphenopalatine Ganglion Block.
user
Does bilateral sphenopalatine ganglion blockade improve postoperative analgesia after endoscopic sinus surgery? Context: Endoscopic sinus surgery (ESS) is a common procedure preferably done with an anesthetic technique ensuring effective postoperative analgesia while speeding discharge home. Although anesthesia administered locally in conjunction with vasoconstricting agents is  known to minimize intraoperative bleeding, its usefulness in providing postoperative analgesia has not been well characterized. The results supporting the use of regional anesthesia for sinus surgery have also been limited. Using a randomized, double-blinded and placebo-controlled design,  we evaluated recovery times, opioid consumption, and nausea and vomiting after ESS when patients were randomized to either general anesthesia (GA) alone or with regional blockade. Subjects were 70 adults scheduled for sinus surgery. All participants underwent propofol/remifentanil/nitrous  oxide anesthesia and similar intraoperative care. Patients received either GA alone or with sphenopalatine ganglion (SPG) blocks in a double-masked study design. Independent observers recorded readiness for discharge, incidence of nausea/vomiting, and pain scores every 15 minutes until discharge.  Overall opioid use in the recovery area was also a secondary end point. Twenty-four hours later, patients were called and asked to rate their pain and overall satisfaction with their pain control. Block group participants were considered ready for discharge after  45 minutes and discharged from the hospital ∼40 minutes sooner than GA group participants. The block group required less total fentanyl in the recovery room than did the GA group. The incidences of nausea and vomiting did not differ significantly. Data at 24 hours postoperatively did not  differ significantly between groups but trended toward increased satisfaction in the block group. No lasting adverse events were observed.
assistant
Regional anesthesia using targeted nerve blocks is effective in ESS. The combination of GA and SPG blockade appears to  shorten hospital stay and reduce narcotic requirements in the recovery area. No demonstrable benefits were observed after 24 hours regarding pain management. Final Decision: yes