DOI: https://doi.org/10.36347/sjams.2026.v14i02.001

Pages: 107-112

Introduction: Tympanoplasty, a surgical procedure for tympanic membrane perforation, is traditionally performed under general anesthesia. However, performing it under local anesthesia without sedation offers potential advantages, including reduced cost, avoidance of general anesthesia risks, and faster recovery. Objective: To evaluate the feasibility and outcomes of tympanoplasty under local anesthesia without preoperative sedation. Methods: A cross-sectional study was conducted at Bangladesh Medical College Hospital from October 2022 to June 2023. A purposive sample of 66 patients with chronic suppurative otitis media (tubotympanic type) undergoing tympanoplasty under local anesthesia (2% Lidocaine) without sedation was included. Preoperative anxiolytic (Bromazepam) was administered. Patient discomfort (anxiety, pain, uneasiness, backache, noise, claustrophobia) and surgeon's assessment of operative conditions (movement, pain, bleeding, etc.) were evaluated using defined scores (0-4). Postoperative complaints and satisfaction were also recorded. Results: Analysis of 66 patients with a mean age of 31 years revealed that tympanoplasty under local anesthesia without sedation was successfully performed in all cases. Patient discomfort scores for pain and noise were low, at 1.30 and 1.29, respectively. The most significant patient complaint was backache, with a mean score of 1.95. Surgeons reported a very low operative problem score of 0.41. Notably, postoperative patient satisfaction was high, with 72.73% of patients reporting excellent satisfaction. Conclusion: Tympanoplasty under local anesthesia without sedation is a viable and well-tolerated technique for selected patients. It yields high patient satisfaction and efficient resource use, making it a safe and effective alternative to general anesthesia in appropriate clinical settings.