[Local analgesia in postoperative cleansing of head and neck infected wounds]. / Analgesia local en el aseo postoperatorio de heridas infectadas de cabeza y cuello.

INTRODUCTION: After debridement of head and neck abscess, patients require multiple post-surgical cleansing procedures that produce mild or severe pain because are performed without any effective analgesia. Sedation techniques could not be applied at every cleansing process and even local anesthesia injected into the tissues during the procedure is contraindicated. MATERIAL AND METHODS: We present the results of pain control obtained in 600 cleansing procedures performed by irrigating an anesthetic solution over wound tissues exposed after surgical head and neck abscess debridement. RESULTS: All patients had previous surgical debridement of head and neck abscess. All were irrigated with lidocaine solution because dressings were eliminated during every cleansing process. During 5 days of follow-up, at the first and second day only 12.5% of cases reported severe pain when dressing materials were eliminated; at the third day, only one patient (2.5%) reported severe pain when dressings were eliminated. On the first day during surgical cleaning procedure, 25% of cases reported severe pain and 25%, moderate pain; on the second day, 3.3% reported severe pain and 14.1% reported moderate pain. On the third day, 0.8% reported severe pain and 6.6% reported moderate pain; while on the fourth day, no one reported severe pain and only 12.5% reported moderate pain. On the fifth day, noone reported severe pain and only 0.8% reported moderate pain. DISCUSSION: The surgical cleansing methods applied in wounds originated in head and neck abscess debridement produce pain that could be controlled by irrigating lidocaine solution immediately before and during the process of cleansing and is an alternative method bacause general anesthesia, profound sedation, and direct anesthetic injection are contraindicated. This technique was effective in a limited fashion because multiples factors modified local analgesia. This technique should be used in decontamination because dressing materials are eliminated and before wound cleansing action begins.