>Cirugía y Cirujanos
>Year 2003, Issue 4
Oviedo-Montes A, Peña-García JF, Antonio-Ocampo A, Velázquez-Chong HA, Jurado-Reyes JG, Ramírez-Martínez ME, Castro-Ibarra S
Local analgesia in postoperative cleansing of head and neck infected wounds
Cir Cir 2003; 71 (4)
PDF: 48.93 Kb.
Introduction: After debridement of head and neck abscess, patients
require multiple post-surgical cleansing procedures that produce mild
or severe pain because are performed without any effective analgesia.
Sedation techniques could not be applied at every cleansing process and
even local anesthesia injected into the tissues during the procedure is
Material and methods: We present the results of pain control obtained in
600 cleansing procedures performed by irrigating an anesthetic solution
over wound tissues exposed after surgical head and neck abscess debridement.
Results: All patients had previous surgical debridement of head and neck
abscess. All were irrigated with lidocaine solution because dressings were
eliminated during every cleansing process. During 5 days of follow-up, at
the first and second day only 12.5% of cases reported severe pain when
dressing materials were eliminated; at the third day, only one patient
(2.5%) reported severe pain when dressings were eliminated. On the first
day during surgical cleaning procedure, 25% of cases reported severe pain
and 25%, moderate pain; on the second day, 3.3% reported severe pain and
14.1% reported moderate pain. On the third day, 0.8% reported severe pain
and 6.6% reported moderate pain; while on the fourth day, no one reported
severe pain and only 12.5% reported moderate pain. On the fifth day,
noone reported severe pain and only 0.8% reported moderate pain.
Discussion: The surgical cleansing methods applied in wounds originated
in head and neck abscess debridement produce pain that could be controlled
by irrigating lidocaine solution immediately before and during the process
of cleansing and is an alternative method bacause general anesthesia,
profound sedation, and direct anesthetic injection are contraindicated.
This technique was effective in a limited
fashion because multiples factors modified local analgesia. This
technique should be used in decontamination because dressing materials
are eliminated and before wound cleansing action begins.
||Infection, pain, abscess, debridement, lidocaine.
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>Cirugía y Cirujanos
>Year 2003, Issue 4