A randomized controlled trial evaluating the hemodynamic impact of ultrasound-guided great auricular nerve block in midd
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RESEARCH ARTICLE
Open Access
A randomized controlled trial evaluating the hemodynamic impact of ultrasoundguided great auricular nerve block in middle ear microsurgery Jinsheng Liu1, Kezhi Yuan1, Hongling Zhou1, Li Li2, Guyan Wang1* and Tianzuo Li3*
Abstract Background: The peri-operative effectiveness of ultrasound-guided great auricular nerve block (GANB) in patients, especially in adult patients undergoing middle ear microsurgery remains unclear. We hypothesized that ultrasoundguided GANB would decrease the hemodynamic responsiveness to incision and opioid consumption in middle ear microsurgery as well as the post-operative analgesia requirement. Methods: Sixty patients undergoing middle ear microsurgery were randomized into two equal groups to receive either a GANB with 2 ml of 0.25% ropivacaine under ultrasound guidance (GANB group) or to receive a blank control intervention (without any performed injection) before general anesthesia inductions. The primary outcomes were hemodynamic changes of MAP (mean artery pressure) and HR (heart rate) to skin incision. The secondary endpoints were to determine the consumptions of propofol and remifentanil during the operation and the incidence of remedial analgesia 48 h post-operation to maintain VAS ≤ 3. Results: The MAP post incision in GANB group was significantly lower than that in control group (GANB group 93.83 ± 11.72 mmHg vs. control group 100.87 ± 12.65 mmHg, P = 0.029). The increases for MAP and HR post incision were also lower in GANB group (ΔMAP GANB group 11.90 ± 8.32 mmHg vs. control group 19.83 ± 10.37 mmHg, P = 0.002; ΔHR GANB group 3.67 ± 5.30 beat min− 1 vs. control group 8.23 ± 8.56 beat min− 1, P = 0.016). Remifentanil consumption was significantly decreased in GANB group (GANB group 401.55 ± 100.51 μg h− 1 vs. control group 697.34 ± 215.45 μg h− 1, P = 0.000). The incidence of remedial analgesia post-operation in GANB group (5/30) was significantly lower than that in control group (20/30, P = 0.000). Conclusion: Ultrasound-guided GANB decreases the hemodynamic responsiveness to incision and remifentanil consumption in middle ear microsurgery as well as the post-operative analgesia requirement. Trial registration: This trial was retrospectively registered at http://www.chictr.org.cn with the registration number of ChiCTR1800014333 on 6 January, 2018. Keywords: Ultrasonography, Ear, middle, Nerve block, Hemodynamics
* Correspondence: [email protected]; [email protected] 1 Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China 3 Department of Anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a li
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