Minimally Invasive Interventions in Obstructive and Inflammatory Salivary Gland Diseases: Local Anesthesia Based Pain Management, Stratification of Invasiveness, and Patients’ Perceptions

<b>Objectives:</b> Since the peri- and intraoperative management of patients with inflammatory and obstructive sialadenitis (IOS) differs significantly between treating centers worldwide, we investigated whether these patients can be treated successfully, resource-savingly and with high patient satisfaction using minimally invasive procedures under local anesthesia (LA). <b>Methods:</b> We developed a comprehensive, stratified routine anesthesia and pain management protocol based on our proposed classification of invasiveness (grade 1-4), for almost all available IOS treatment procedures. We included 377 patients with 470 LA-conducted interventions in our study and evaluated their perceptions during and after the treatment. <b>Results:</b> The protocol was applied to all 377 study participants for all 470 interventions. The mean grade of invasiveness was 2.49 ± 1.31, with a mean procedure duration of 30 ± 20 min. We found a significant positive association between invasiveness levels and procedure duration (<i>p</i> = 0.001) or pain directly after surgery (<i>p</i> = 0.004). Patients rated the procedures as "well acceptable" or better in a large majority (88.1-97%) regarding the administration and potency of LA, procedure duration, and pain during and directly after surgery. In total, 96.4% of patients would have the treatment repeated under the same conditions. <b>Conclusions:</b> The proposed anesthesia and pain management regimen, respecting invasiveness levels, enables IOS patients to undergo treatment under LA with high success rates, serving as a potential guide for performing physicians.