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#35886 Feasibility and efficacy of ultrasound guided cervical sympathetic plexus block with continuous infusion of local anesthetics to treat acute post-surgical pain after transoral robotic surgery head and neck surgery
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  1. Siamak Rahman1,
  2. Abie Mendelsohn2,
  3. Parisa Partownavid1,
  4. Benjamin Chu1,
  5. Emily Wong2 and
  6. Tristan Grogan1
  1. 1Department of Anesthesiology and Perioperative Medicin, University of California, Los Angeles, Los angeles, USA
  2. 2Head and Neck Surgery, University of California, Los Angeles, Los angeles, USA

Abstract

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Background and Aims Rising oropharyngeal cancer among men and women is a documented public health concern. Surgical treatment and post-surgical care of these patients are very challenging and among them odynophagia in the first 2 weeks after surgery is highly concerning. In addition to suffering that is caused by pain, poor oral intake and hence inability to take oral pain medications keeps these patients bound to hospital and is the cause of readmission and Emergency room visits during 1st 2 weeks after surgery. The goal of this study is to examine feasibility and efficacy of utilizing continuous infusion of local anesthetics to lower cervical sympathetic plexus (Stellate ganglion) for treating acute postoperative pain in patients undergoing TORS for treatment of HNC.

Methods Post induction catheter placement of Stellate ganglion and infusion of local anesthetics for up to 2 weeks in 45 patients underwent TORS for oropharyngeal tumor resection. Results compared with historical data, 32 patients.

Results Patients who received a SGB had a statistically significant reduction in MME on POD 0, 2 and 3. MME use in SGB group was lower on POD 1 as well, however this did not reach statistical significance. There were no statistically significant differences in MME use between the two grousp beyond POD3 and there were no statistically significant differences in PONV or average VAS pain scores between the two groups

Conclusions It is feasible and somewhat effective to use SGB block for treatment of acute pain after oropharyngeal tumor resection. No complication was noticed directly or indirectly related to SGB.

Attachment ethics_IRB.pdf

  • sympathetic Block
  • Stellate ganglion
  • continuous infusion of Local anesthetics
  • post-surgical pain

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