Anesthetic Concerns in Patients Receiving Preoperative Opioids: a Review

Objectives: To evaluate the advantages and disadvantages along with comparison of results of endoscopic septoplasty over conventional septoplasty. Methods: The prospective type of study was conducted in a tertiary referral centre and a total of 60 patients between the ages group of 18-35 years having symptomatic deviated nasal septum and refractory to conservative medical treatment were included in the study while patients with uncontrolled hypertension or diabetes, having upper respiratory tract infection or allergic rhinitis were excluded from the study. Patients were divided into two groups: Group A-consisted of 30 patients, in whom conventional septoplasty was done and Group B-consisted of 30 patients, in whom endoscopic septoplasty was performed. Post-operative assessment was carried out at 48hrs, 15days, 1 month and 3 months after the surgery. Results: 24 (80%) patients of Group A had improvement in nasal obstruction, 18 (90%) showed symptomatic relief from nasal discharge and headache was relieved in 17 (85%) patients. In Group B, 27 (90%) patients had improvement in nasal obstruction, 20 (90.9%) showed relief from nasal discharge and headache was relieved in 20 (95.2%) patients. Residual septal deviation was seen only in 3 (10%) patient of Group A. 3 (10%) cases developed synechiae in Group A as compared to 1 (3.3%) case in Group B. Lip oedema developed only in 3 (10%) of cases in Group A. Bleeding from nose requiring repacking was seen in 3 (10%) patients of Group A and 1 (3.3%) in Group B. Conclusion: Endoscopic septoplasty showed better results as compared to conventional septoplasty as endoscope gives better illumination and improved access to deviated nasal septum and allows limited incision, limited flap elevation, and achieves correction with least resection and thus reducing the post-operative complications.