Cirugía y Cirujanos

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >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)

Language: Español
References: 23
Page: 270-274
PDF: 48.93 Kb.

Full text


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 contraindicated. 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.

Key words: Infection, pain, abscess, debridement, lidocaine.


  1. Zangenbruner DJ, Dajani S. Pharingomaxillary space abscess with carotid artery erosion. Arch Otolaryngol 1971;94:447.

  2. Johnson JT. Abscesses and deep neck infections in the head and neck. Infect Dis Clin North Am 1992;6:705-717.

  3. Zide MF, Limchayseng LRG. Complications of head and neck infections. Oral Maxillofac Clin North Am 1991;3: 355.

  4. Marciani RD. Clinical considerations in head and neck infections. In: Peterson LJ, Indresano AT, Marciani RD, Roser SM, editors: Principles of oral and maxillofacial surgery. Philadelphia PA, USA: JB Lippincott; 1992.pp.163-200.

  5. Goldberg MH, Topazian RG. Odontogenic infections and deep fascial space infections of dental origin. In: Topazian RG, Goldberg MH (editors): Oral and maxillofacial infections. 4th. Ed. Philadelphia PA, USA: WB Saunders; 2002.pp.158-187.

  6. Chow AW. Life-threatening infections of the head and neck. Clin Infect Dis 1992;14:991-1002.

  7. Tom MB, Rice DH. Presentation and management of neck abscesses: a retrospective analysis. Arch Otolaryngol Head Neck Surg 1988;113:661.

  8. Blanchaert RH Jr. Identification, management, and prevention of infections after head and neck surgery. In: Topazian RG, Goldberg MH (eds): Oral and maxillofacial infections. 4th Philadelphia PA, USA: WB Saunders; 2002.pp.399-409.

  9. Horswell BB. Infections. In: Kwon PH, Laskin DM, editors. Clinician´s manual of oral and maxillofacial surgery. 3rd. Ed. Chicago IL, USA: Quintessence Publishing Co.; 1997.pp.307-309.

  10. Mallampati SR, Gott SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985;32:429-434.

  11. American Heart Association: Textbook of advanced cardiac life support, Dallas, TX, USA: American Heart Association; 1987.

  12. Bennet JD, Flynn TR. Anesthetic considerations. Orofacial infections. In: Topazian RG, Goldberg MH editors: Oral and maxillofacial infections 4th. Ed. Philadelphia PA, USA: WB Saunders; 2002.pp.439-455.

  13. Dzyak WR, Zide MF. Diagnosis and treatment of lateral pharyngeal space infections. J Oral Maxillofacial Surg 1984;42:243-249.

  14. Barrat GE, Koopman CF, Coulthard L. Retropharyngeal abscess: a ten-year experience. Laryngoscope 1984;94:455-463.

  15. Henry CH, Hughes CV, Larned DC. Odontogenic infection of the orbit. J Oral Maxillofac Surg 1992;50:172.

  16. Zimmerman RA, Bilaniuk LT. Orbital infection and its cerebral complications. Am J Roentgenol 1980;31:134-145.

  17. Jackson BS, Sproat JE. Necrotizing fascitis of the head and neck with intrathoracic extension. J Otolaryngol 1995;24:60.

  18. Benumof JL. Management of the difficult airway. Anesthesiology 1991;75:1087.

  19. Arne J, Desoins P, Fusciardi J, et al. Preoperative assessment for difficult intubation in general and ENT surgery: predictive value of a clinical multivariate risk index. Br J Anaesth 1998;80:140.

  20. Brown RD. The failure of local anaesthesia in acute inflammation: some recent concepts. Br Dent J 1981;151:47-51.

  21. Yagiela JA. Local anesthetics. In: Dionne RA, Phero JC, editors. Management of pain and anxiety in dental practice. New York: Elsevier; 1991.pp.109-134.

  22. Brown AC, Sataloff RT. Special anesthetic techniques in head and neck surgery. Otolaryngol Clin North Am 1981;14: 587.

  23. Oviedo MA, Ramblas AP, Saucedo NE, Sánchez DJ. Desbridación de abscesos submandibulares bajo bloqueo locorregional. Gac Med Mex 1992;128:3,275-278.

>Journals >Cirugía y Cirujanos >Year 2003, Issue 4

· Journal Index 
· Links 

Copyright 2019