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Abstract
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Background and Aims Auricular reconstruction surgery involving the harvesting of rib cartilage is a challenging and extensive procedure, frequently necessitating adequate pain control in the post-operative period. This article examines the potential use of superficial cervical plexus block (SCPB) and paravertebral block (PVB) as an effective analgesic method for this particular surgical procedure.
Methods A fifteen-year-old boy weighing 51 kg, with microtia in the left ear and ASA-PS I, underwent reconstructive auricular surgery involving rib cartilage harvesting. The patient was administered fentanyl 100 µg, propofol 100 mg, rocuronium 30 mg for induction, and sevoflurane at a concentration of 2 vol% for maintenance.We conducted USG-guided SCPB and PVB with 5 ml and 20 ml of bupivacaine 0.25% + epinephrine 1:200,000 respectively. The surgery lasted for 6 hours and with no additional opioids. Paracetamol 3× 1000 mg and ketorolac 3×30mg was provided for post operative pain management.
Results The NRS in the recovery room was 0. Twenty-four hours after the surgery, it ranged from 1 to 3. The patient experienced mild discomfort at the surgical site where a rib was harvested but could sleep well and reported no pain around the ear.
Conclusions The use of SCPB and PVB for perioperative analgesia in auricular reconstruction surgery with rib cartilage harvesting has shown promising results in providing effective pain control.The patient‘s ability to sleep well and report no pain around the ear and mild discomfort around the harvested rib reflects the success of this analgesic technique in enhancing patient comfort and satisfaction during the perioperative phase.
superficial cervical plexus block
paravertebral block