Dr Divya Gautam, Dr Anoop Raj Gogia, Dr Shruti Malik, Dr Chirag Madaan


INTRODUCTION: Postoperative pain can be mitigated by using a combination of drugs as well as peripheral nerve blocks. Use of peripheral nerve blocks helps reduce the requirement of other analgesic agents reducing their side effects. The objectives of this study were:

1. to study postoperative pain relief following Greater Auricular Nerve Block in patients undergoing tympanomastoid surgery

2. comparison of postoperative pain relief following greater auricular nerve block with conventional means of pain relief using NSAIDS( Non-steroidal anti-inflammatory agents)

MATERIALS AND METHODS: In this prospective randomized study 70 ASA I patients undergoing tympanomastoid surgery were selected to examine the efficacy of greater auricular nerve block to provide postop analgesia in comparison to that provided by Diclofenac. Apart from requirement of postop rescue analgesic requirement any side effects of the interventions used were also studied. Patients were randomly assigned to any of the two groups and informed consent was taken preop. General anaesthesia with endotracheal intubation was used in all patients with intravenous fentanyl used as intraop analgesic. 15 minutes prior to completion of surgery Group A patients received Greater Auricular Nerve Block while Group B patients received i.v. diclofenac 1mg/kg. Patients were extubated and pain relief assessed with Visual Analogue Score (VAS) at predetermined intervals for a period of 24 hours. i.v. Paracetamol 15 mg/kg was used as rescue analgesic if VAS>4. Any side effects were also recorded.

RESULTS: The requirement of rescue analgesia was lesser in Group A than Group B and the difference was statistically significant (p value <0.001). No side effects were noted postoperatively in either groups. This study concluded that Greater auricular nerve block provided effective analgesia in patients undergoing tympanomastoid surgery and reduced the requirement of rescue analgesia postop.

CONCLUSION: Greater auricular nerve block provides better pain relief than conventional methods in terms of better VAS score, reduced requirement of rescue analgesia as well as delay in the requirement of first rescue analgesic postop.


greater auricular nerve block, NSAIDS, VAS score, Tympanomastoid surgery, postoperative analgesia

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