Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (1): 15-19.doi: 10.6040/j.issn.1673-3770.0.2021.538

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Effect of great auricular nerve block on emergence delirium in children undergoing cochlear implantation

FENG Yanyan1, ZHANG Danxu1, ZHANG Kangda1, WANG Linyu1, WANG Huanliang1,2,3   

  1. 1. Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan 250014, Shandong, China;
    2. Department of Anesthesiology, The Second Affiliated Hospital of Hainan Medical University, Haikou 570100, Hainan, China;
    3. Shenzhen Research Institute of Shandong University, Shenzhen 518000, Guangdong, China
  • Published:2023-02-06

Abstract: Objective To evaluate the effect of great auricular nerve block on emergence delirium(ED)in children undergoing cochlear implantation with sevoflurane general anesthesia. Methods We enrolled 80 children(0-6 years)with American Society of Anesthesiologists status Ⅰ or Ⅱ who were scheduled for unilateral cochlear implantation under sevoflurane general anesthesia. The patients were randomly assigned to the great auricular nerve block group(group A)or the control group(group B). After the induction of anesthesia, 1 mL of 0.2% ropivacaine was injected around the auricular nerve under ultrasound guidance in group A, while 2 mL of 2% lidocaine was injected around the incision in group B. General anesthesia was maintained with sevoflurane. The incidence of ED was assessed using the pediatric anesthesia acute delirium scale(PAED), while postoperative pain was assessed using the face, legs, activity, cry and consolability(FLACC)scale. Patients with a PAED≥13 or FLACC≥4 were given fentanyl 0.5 μg/kg intravenously. Average sevoflurane dosage, ED duration, extubation time, duration of post-anesthesia care unit(PACU)stay, total fentanyl dosage, nurse satisfaction score, and incidence of adverse reactions within 24 hours postoperative were recorded. Results The incidence of ED(P=0.036)and PAED(P=0.024)score were significantly decreased in group A versus B, FLACC score(P=0.008)and the incidence of FLACC≥4(P=0.006)were significantly decreased, the incidence of analgesia with fentanyl(P=0.011)was significantly decreased, duration of PACU(P=0.040)residence was significantly shortened, and nurse satisfaction(P=0.021)was significantly improved(all P<0.05). No significant change was found in group A in the incidence of PAED≥13(P=0.289), ED duration(P=0.962), extubation time(P=0.913), and the incidence of postoperative adverse reactions(PVomit=0.737;Pchoking=0.487;Phypoxia=1.000)(all P>0.05). Conclusion A great auricular nerve block can reduce the incidence of ED and postoperative pain in children under sevoflurane general anesthesia without increasing the incidence of postoperative adverse events.

Key words: Emergence delirium, Great auricular nerve block, Child, Cochlear implantation, Postoperative pain

CLC Number: 

  • R614.4
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