Awake stapedectomy under hypnoanalgesia: Efficacy and safety in the treatment of otosclerosis

IF 2.4 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases Pub Date : 2025-07-01 DOI:10.1016/j.anorl.2025.04.001

E. Caillaud , L. Pellé-Boudeau , M. Férrandière , D. Bakhos , E. Lescanne , F. Micaletti

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引用次数: 0

Abstract

Objective

To evaluate the efficacy and safety of awake stapedectomy under hypnoanalgesia (HA) compared to general anesthesia (GA) and local anesthesia (LA) in patients with otosclerosis.

Methods

A single-center retrospective study included 131 adult patients (mean age: 49 years; 78% female) who underwent laser stapedectomy between 2020 and 2022: 58 GA, 23 LA, 50 HA. Primary outcome measures comprised operative room occupancy time, anesthetic consumption, and postoperative audiometric results.

Results

HA significantly reduced operative room occupancy time (73.5 ± 18.6 min vs 103.7 ± 24.6 min in GA, P < 0.001; vs 81.8 ± 20.5 min in LA, P = 0.092), stapedectomy duration (39.9 ± 12.4 min vs 48.9 ± 21.5 min in GA, P = 0.0252; vs 38.9 ± 13.2 min in LA, P = 0.4601), preoperative time (30.2 ± 9.5 min vs 45.7 ± 9.5 min in GA, P < 0.001; vs 38.6 ± 12.2 min in LA, P = 0.0022), and recovery room time (26 ± 15.1 min vs 67.5 ± 20.7 min in GA, P < 0.001; vs 47.4 ± 20.7 min in LA, P < 0.001). HA also significantly reduced remifentanil consumption (169.8 ± 101.6 μg vs 848.6 ± 308.8 μg in GA, P < 0.001; vs 323.9 ± 94.4 μg in LA, P < 0.001). Postoperative audiometric outcomes showed no significant differences between groups.

Conclusion

Hypnoanalgesia for awake stapedectomy provided significantly greater efficacy compared to general anesthesia, reducing operative time and anesthetic consumption, with comparable audiometric outcomes.

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催眠镇痛下清醒镫骨切除术治疗耳硬化的疗效和安全性。

目的：比较催眠镇痛（HA）与全麻（GA）、局麻（LA）对耳硬化患者行清醒镫骨切除术的疗效和安全性。方法：单中心回顾性研究纳入131例成人患者(平均年龄49岁；在2020年至2022年间接受激光镫骨切除术的患者（78%为女性）：58名GA， 23名LA， 50名HA。主要指标包括手术室占用时间、麻醉消耗和术后听力学结果。结果：透明质酸显著减少了手术时间（73.5±18.6min vs 103.7±24.6min）。结论：与全麻相比，醒时镫骨切除术的催眠镇痛效果明显更好，减少了手术时间和麻醉消耗，听力指标相当。

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来源期刊

European Annals of Otorhinolaryngology-Head and Neck Diseases OTORHINOLARYNGOLOGY-

CiteScore

3.70

自引率

28.00%

发文量

审稿时长

12 days

期刊介绍： European Annals of Oto-rhino-laryngology, Head and Neck diseases heir of one of the oldest otorhinolaryngology journals in Europe is the official organ of the French Society of Otorhinolaryngology (SFORL) and the the International Francophone Society of Otorhinolaryngology (SIFORL). Today six annual issues provide original peer reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches and review articles giving most up-to-date insights in all areas of otology, laryngology rhinology, head and neck surgery. The European Annals also publish the SFORL guidelines and recommendations.The journal is a unique two-armed publication: the European Annals (ANORL) is an English language well referenced online journal (e-only) whereas the Annales Françaises d’ORL (AFORL), mail-order paper and online edition in French language are aimed at the French-speaking community. French language teams must submit their articles in French to the AFORL site. Federating journal in its field, the European Annals has an Editorial board of experts with international reputation that allow to make an important contribution to communication on new research data and clinical practice by publishing high-quality articles.