Evalution of the effectiveness of local anesthetics during septoplasty and tonsillectomy

Surgical trauma provokes body's stress response with activation of inflammatory, endocrine, metabolic, and immunological factors, which is believed to be necessary and beneficial response. Aim of the study was to compare the effectiveness of local anesthetics lidocaine and articaine in septoplasty and tonsillectomy in terms of assessing the severity of stress reactions. Patients and Methods: 125 patients with nasal septum deviation (NSD) and chronic tonsillitis (CT) were observed. Patients with NSD were divided into 2 groups: 1A 32 patients treated by 2% lidocaine local infiltration analgesia (LIA); 1B 30 patients treated by 2% articaine LIA. Corresponding groups of patients with CT were 2A (32 patients) and 2B (31 patients). For all patients, heart rate variability (HRV), high, low and very low frequency components were measured. Results: Estimation of group variances of HRV showed there were some disadaptation in groups 1B and 2A. High dispersion of SDANN, SDNN index and rMSSD in 1B group, SDANN values in 2A group indicate the sympathetic/parasympathetic imbalance. High frequency component were augmented in 2B group which pointed out prevailing parasympathetic tone but its high dispersion was indicative of disadaptation as well. Conclusion: Thus, with the local infiltration application of an articaine solution during septoplasty, the autonomic nervous system dystonia is observed in the early postoperative period. When anesthesia with lidocaine solution during tonsillectomy, there is also a breakdown of adaptive responses against the background of surgical stress. Based on the above data, of the presented local anesthetics, lidocaine is more effective in septoplasty, and articaine in tonsillectomy.