Materials and methods
In this prospective case-control study, we included patients aged over 18 years who underwent coblation inferior turbinoplasty at our hospital. A total of 42 patients were identified, with 22 treated under LA and 20 treated under GA. Due to the disruption of elective services by COVID-19 pandemic, we included GA patients from the period prior to pandemic (January 2019 to March 2020). LA procedures were performed between March 2021 and January 2022. The inclusion criteria were ASA grade 1-2, chronic non-allergic rhinitis refractory to medical treatment and confirmed with negative skin-prick or RAST test.
All patients 42 completed the study and were followed up in outpatient clinic 3 months after discharge. We measured these outcomes between studied groups: change in overall NOSE scores between pre-operative visit and 3 months postoperatively, pain scores, waiting times for procedure and costs.
Moreover, we wanted to assess the differences in length of inpatient stay. Due to heterogeneity of admission and anaesthetic protocols, we decided to measure time between:
Arrival to outpatient clinic/day surgery admission lounge and discharge home (Total time)
Arrival to recovery and discharge (Recovery time)
We also screened these complications: excessive bleeding requiring re-admission, prolonged stay/insertion of packing/revision surgery for bleeding, infection requiring antibiotics and adhesions at 3 months follow up. The patients were asked to rate their pain postoperatively at 1 hour using visual analogue scale (VAS) (0 = no pain, 10 = most severe pain). Just before discharge, we asked patients included in the LA cohort whether they ‘Would you recommend turbinoplasty under local anaesthesia to a friend ?’. We present the screening algorithm that was used in real-life setting (Figure 1).
This study served as an evaluation of practice and was approved by our Hospital Clinical Governance Department.