| Abstract [eng] |
Introduction. A fracture of the nasal bones is one of the most common facial area fractures. Most of them are treated by performing a closed reduction. Although general anesthesia is probably the most commonly used anesthesia technique for this surgical intervention, procedural sedation using ketamine remains a truly interesting choice as well. Aim. To compare intravenous sedation using ketamine in combination with other drugs with general anesthesia, during a closed reduction of nasal bones fracture. Objectives. To compare study groups according to the durations of surgical procedure, anesthesia and postoperative follow-up, patients hemodynamic and respiratory function parameters, level of sedation and experienced pain, adverse events and complications that occurred. Methods. A retrospective analysis of the medical records of 63 patients, who from January 1, 2017 to August 31, 2021 had a fracture of the nasal bones and for whom it was decided to use surgical treatment, was performed. Results. No significant difference was found between study groups in terms of duration of closed reduction of nasal bones fracture. Significantly shorter duration of anesthesia, more awake patients and a possibility to earlier transfer them safely to the Department of Ear, Nose and Throat Diseases were observed when procedural sedation with ketamine was used. With the latter anesthesia technique, systolic and diastolic arterial blood pressures maintained greater stability during surgery and immediate postoperative period, while heart rate varied less when general anesthesia was chosen. In terms of peripheral blood oxygen saturation, significant differences between study groups were minimal and did not have a major impact in actual clinical practice. There were no significant differences between study groups in terms of experienced pain, adverse events and complications that occurred. Conclusions. Intravenous sedation using ketamine in combination with other drugs not only is non-inferior, but may also have some advantages over general anesthesia, during a closed reduction of nasal bones fracture, consequently this anesthesia technique can be recommended for use in clinical practice. However, the need for further research, especially prospective studies with a larger number of patients, remains. |
