Anesthetic and Analgesic Efficient of Regional Nerve Blockade in Otoplasty
Abstract
AIM: The prominent ear is the most common congenital deformity of the external ear. Otoplasty is performed to correct the appearance of the prominent ear. This study was planned to compare the analgesic and anesthetic effects of local nerve blockade and local infiltration anesthesia in the otoplasties. METHOD: Thirty-two patients who underwent otoplasty in both ears between February 2018 and March 2019 were included in the study. Three patients were excluded because they refused regional anesthesia. In the patients included in the study, only local infiltration anesthesia was applied to 1 ear and regional nerve blockade was applied to the other ear. Regional nerve blockade was applied to the study group; local infiltration anesthesia was applied to the control group. Surgical and anesthetic complications were recorded. The onset time, duration and severity of pain were followed. Numerical evaluation scale scores were used to evaluate pain levels. RESULTS: It was observed that the first pain of the patients On the side where regional nerve block (RNB) anesthesia was applied after an average of 10.5 hours. On the other hand on the side where local infiltration anesthesia was applied; the pain was observed to start after an average of 3.5 hours. At the 6th and 12th hours postoperatively, the scores of the numerical evaluation scale were significantly lower in the study group than the control group (P < 0.05). At the 24th-hour pain score, the values were lower in the study group, but the difference was not significant between the groups (P > 0.05). In the regional anesthesia group, can develop such as difficulty in swallowing, weakness in the neck, weakness in the upper extremity, nausea, Horner syndrome; but all side effects resolve spontaneously within 6 to 12 hours. CONCLUSION: The application of regional anesthesia in prominent ear surgical procedures can be considered as an alternative method to provide better quality preoperative anesthesia and better quality postoperative analgesia in patients.
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Two trials recorded statistically significant reductions in NRS scores within the first 12 hours, accompanied by lower rescue opioid use.
“Two trials recorded statistically significant reductions in NRS scores within the first 12 hours, accompanied by lower rescue opioid use.1,7”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
Targeted prophylaxis-chiefly transdermal hyoscine or total intravenous anesthesia with propofol-substantially mitigated PONV risk.
“Targeted prophylaxis—chiefly transdermal hyoscine or total intravenous anesthesia with propofol—substantially mitigated this risk.28”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [28]
Where duration was reported, a single regional nerve block injection provided 8 hours or more of analgesia.
“Where duration was reported, a single RNB injection provided 8 hours or more of analgesia1,7; subsequent oral or parenteral drugs were administered only as needed.1,7,19”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
Cervical plexus blocks occasionally produced mild hoarseness or self-limiting Horner syndrome-like symptoms.
“Cervical plexus blocks occasionally produced mild hoarseness or self-limiting Horner syndrome–like symptoms,1 and hyoscine patches were associated with brief visual disturbance or bradycardia in a small number of children.18”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
Taken together, the evidence supports regional nerve block as the preferred technique for sustained analgesia in otoplasty, with multiple studies demonstrating clinically-and in several trials statistically-meaningful benefits over local infiltration anesthesia.
“Taken together, the evidence supports RNB as the preferred technique for sustained analgesia in otoplasty, with multiple studies demonstrating clinically—and in several trials statistically—meaningful benefits over LIA.1,7,24”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
The Kepekçi and Kepekçi trial enrolled only 35 patients, so its results should be interpreted cautiously.
“These results, although significant, should be interpreted cautiously because the trial enrolled only 35 patients.”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
Same-day discharge was more frequent when propofol, regional nerve block, or local anesthetic with sedation formed part of the regimen, whereas overnight observation was usual after conventional inhalational anesthesia or exclusive reliance on local infiltration anesthesia.
“Same-day discharge was more frequent when propofol, RNB, or local anesthetic with sedation formed part of the regimen,1,19,21 whereas overnight observation was usual after conventional inhalational anesthesia or exclusive reliance on LIA.7,15,17”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
No permanent complications were reported.
“however, no permanent complications were reported.1,18”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
In the Kepekçi and Kepekçi RCT, regional nerve block delayed pain onset (10.5 versus 3.5 hours) relative to local infiltration anesthesia.
“In the Kepekçi and Kepekçi1 RCT, RNB delayed pain onset (10.5 versus 3.5 h) and lowered the 6-hour NRS (0.25 versus 2.34; P < 0.001) relative to LIA.”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
Regional nerve block lowered the 6-hour numeric rating scale pain score (0.25 versus 2.34; P < 0.001) relative to local infiltration anesthesia.
“In the Kepekçi and Kepekçi1 RCT, RNB delayed pain onset (10.5 versus 3.5 h) and lowered the 6-hour NRS (0.25 versus 2.34; P < 0.001) relative to LIA.”
From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [1]
Cites
1 retracted
RETRACTED: Cervical plexus block for perioperative analgesia during otoplasty
Ueshima, H., Shimazaki, A., & Otake, H. (2017) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2017.01.038 · Cited by 3 · see citing works
RetractedA systematic review of the pain scales in adults: Which to use?
Karcıoğlu, Ö., Topaçoğlu, H., Dikme, Ö., & Dikme, Ö. (2018) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2018.01.008 · Cited by 1,098 · see citing works
Randomization and allocation concealment: a practical guide for researchers
Doig, G. S., & Simpson, F. O. (2005) · Journal of Critical Care · doi:10.1016/j.jcrc.2005.04.005 · Cited by 664 · see citing works
Lalonde, D. H., Bell, M. S. G., Benoit, P., et al. (2005) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2005.05.006 · Cited by 402 · see citing works
Pain as a Factor Complicating Recovery and Discharge After Ambulatory Surgery
Pavlin, D. J., Chen, C., Penaloza, D. A., Polissar, N. L., & Buckley, F. P. (2002) · Anesthesia & Analgesia · doi:10.1097/00000539-200209000-00025 · Cited by 356 · see citing works
Correction of prominent ears by concha-mastoid sutures
FURNAS, D. W. (1968) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-196809000-00001 · Cited by 329 · cited 1× · see citing works
“To position the Scapha, cartilage excision and Furnas sutures were inserted from the lateral portion of the conchal cartilage.(24)”
MethodA Comprehensive Review of Epinephrine in the Finger: To Do or Not to Do
Denkler, K. A. (2001) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-200107000-00017 · Cited by 279 · see citing works
Pandit, J. J., Satya‐Krishna, R., & Gration, P. (2007) · British Journal of Anaesthesia · doi:10.1093/bja/aem160 · Cited by 259 · see citing works
Pain as a Factor Complicating Recovery and Discharge After Ambulatory Surgery
Pavlin, D. J., Chen, C., Penaloza, D. A., et al. (2002) · Anesthesia & Analgesia · doi:10.1213/00000539-200209000-00025 · Cited by 245 · see citing works
Janis, J. E., Rohrich, R. J., & Gutowski, K. A. (2005) · Plastic and Reconstructive Surgery · doi:10.1097/01.prs.0000156218.93855.c9 · Cited by 159 · see citing works
Digital anesthesia with epinephrine: An old myth revisited
Krunic, A. L., Wang, L. C., Soltani, K., et al. (2004) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2004.05.028 · Cited by 153 · see citing works
Shih, M., Duh, Q., Hsieh, C., et al. (2010) · World Journal of Surgery · doi:10.1007/s00268-010-0698-7 · Cited by 105 · see citing works
Thomson, C. J., & Lalonde, D. H. (2006) · Plastic & Reconstructive Surgery · doi:10.1097/01.prs.0000227632.43606.12 · Cited by 90 · see citing works
Suresh, S., Barcelona, S. L., Young, N. M., Seligman, I., Heffner, C. L., & Coté, C. J. (2002) · Anesthesia & Analgesia · doi:10.1097/00000539-200204000-00015 · Cited by 89 · see citing works
Suh, Y. J., Kim, Y. S., In, J. H., et al. (2009) · European Journal of Anaesthesiology · doi:10.1097/eja.0b013e32832d6913 · Cited by 65 · see citing works
Martusevicius, R., Swiatek, F. A., Joergensen, L. G., et al. (2012) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2012.04.008 · Cited by 62 · see citing works
Howe, N. R., & Williams, J. M. (1994) · The Journal of Dermatologic Surgery and Oncology · doi:10.1111/j.1524-4725.1994.tb03216.x · Cited by 60 · see citing works
Handler, E. B., Song, T., & Shih, C. (2013) · Facial Plastic Surgery Clinics of North America · doi:10.1016/j.fsc.2013.08.001 · Cited by 58 · see citing works
Correction of Prominent Ears Using Buried Mattress Sutures
Mustardé, J. C. (1978) · Clinics in Plastic Surgery · doi:10.1016/s0094-1298(20)32150-7 · Cited by 56 · see citing works
Gürkan, Y., Taş, Z., Toker, K., et al. (2014) · Journal of Clinical Monitoring and Computing · doi:10.1007/s10877-014-9635-x · Cited by 51 · see citing works
Hardy, D. (2005) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/bf03027727 · Cited by 49 · see citing works
Analgesia after otoplasty: regional nerve blockade vs local anaesthetic infiltration of the ear.
Cregg, N., Conway, F., & Casey, W. (1996) · Canadian Journal of Anaesthesia · doi:10.1007/bf03011255 · Cited by 46 · cited 3× · see citing works
“1).(2) Local anesthesia is preferred in otoplasty operations compared to general anesthesia.”
BackgroundSenapathi, T. G. A., Widnyana, I. M. G., Aribawa, I. G. N. M., et al. (2017) · Journal of Pain Research · doi:10.2147/jpr.s138222 · Cited by 44 · see citing works
Mariappan, R., Mehta, J., Massicotte, E. M., et al. (2015) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-015-0382-3 · Cited by 41 · see citing works
Rössel, T., Kersting, S., Heller, A. R., & Koch, T. (2013) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2013.01.002 · Cited by 40 · see citing works
Hadzic's Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia
Hadžić, A. (2011) · Cited by 36 · see citing works
Flores, S., & Herring, A. A. (2015) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2015.10.003 · Cited by 36 · see citing works
Comparison of bupivacaine and lidocaine with epinephrine for digital nerve blocks
Alhelail, M., Alsalamah, M. A., Almulhim, M., et al. (2009) · Emergency Medicine Journal · doi:10.1136/emj.2008.062497 · Cited by 33 · see citing works
Perisanidis, C., Saranteas, T., & Kostopanagiotou, G. G. (2012) · Dentomaxillofacial Radiology · doi:10.1259/dmfr/29945724 · Cited by 30 · see citing works
Kale, S., Aggarwal, S., Shastri, V., et al. (2015) · Indian Journal of Surgery · doi:10.1007/s12262-015-1244-5 · Cited by 22 · see citing works
Shin, H. Y., Kim, D. S., & Kim, S. S. (2014) · Journal of Medical Case Reports · doi:10.1186/1752-1947-8-59 · Cited by 12 · see citing works
Blepharoplasty and Otoplasty: Comparative Sedation with Remifentanil,Propofol, and Midazolam
Ferraro, G. A., Corcione, A., Nicoletti, G., et al. (2005) · Aesthetic Plastic Surgery · doi:10.1007/s00266-004-0028-2 · Cited by 12 · see citing works
Comparative study between selective nerve blocks and the intravenous opioids in mastoid surgery
Swain, S. K., Pradhan, C., Mohanty, S., & Sahu, M. C. (2017) · Egyptian Journal of Ear Nose Throat and Allied Sciences · doi:10.1016/j.ejenta.2017.05.004 · Cited by 10 · see citing works
Horner's syndrome is not a complication of a brachial plexus block
Avidan, A. (2004) · Regional Anesthesia & Pain Medicine · doi:10.1016/j.rapm.2004.02.006 · Cited by 4 · see citing works
Yörükoğlu, H. U., & Gürkan, Y. (2019) · Journal of Anesthesiology and Reanimation Specialists’ Society · doi:10.5222/jarss.2019.55265 · Cited by 1 · see citing works
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Alnufaei, A. H., AlSubaie, F. K., Aljabri, R. A., Aloqayli, S. Z., Alanshmi, S., Alotaibi, S. M., Ajeeb, Z. B., AlGhamdi, L. Y., Kattan, M. E., Alahmadi, B. H., et al. (2026) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000007347
- Authors
- Kepekçi, A. B., & Kepekçi, A. H.
- Affiliations
- Istanbul Yeni Yüzyıl University (TR)
- Corresponding author
- Kepekçi, Ali Bestemi
- Kepekçi, Ahmet Hamdi
- Venue
- Journal of Craniofacial Surgery
- Published
- 2020-05-04
- Volume
- 31
- Issue
- 7
- Pages
- 1951-1954
- ISSN
- 1049-2275 (ISSN-L)
- 1536-3732
- OpenAlex
- W3022386270
- Cited by
- 3
- References
- 35
- Citations by year
- 2026: 1 · 2023: 2
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Craniofacial Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Keywords
- otoplasty, nerve block, local infiltration anesthesia, postoperative pain, postoperative analgesia, prominent ears, Horner's syndrome, anesthesia complications, onset of anesthesia
- MeSH terms
- Adolescent, Adult, Analgesics, Anesthesia, Local, Anesthetics, Local, Ear, External, Humans, Nausea, Nerve Block, Postoperative Pain, Pain, Postoperative, Young Adult
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