Ultrasound-Guided Maxillary Nerve Block in Nasal Surgery.

Abstract

Summary: Emphasis on enhanced recovery after surgery protocols and opioid use reduction have led to a growing interest in alternative pain management strategies. This study describes and evaluates the ultrasound-guided suprazygomatic maxillary (SZM) nerve blocks for patients undergoing functional and cosmetic nasal surgery as an adjunct to postoperative pain management. A retrospective, multicenter analysis was conducted on patients who underwent functional nasal surgery and rhinoplasty and evaluated the impact of SZM blocks on intraoperative anesthetic and opioid use, postoperative pain scores recorded in the postanesthesia care unit (PACU), and PACU length. A total of 64 patients met inclusion criteria. Twenty-five patients received an SZM block before undergoing the procedure, and the remaining patients underwent standard local anesthetic use. SZM blocks significantly reduced the amount of intraoperative pain medication used ( P = 0.02), including hydromorphone ( P = 0.007), when compared with a traditional approach to local anesthetic use. SZM blocks also significantly reduced PACU stay at 1 institution ( P = 0.016). SZM nerve blocks are a simple and effective way to deliver local anesthetic and are associated with decreased intraoperative opioid use and PACU stay.

Clinical question/level of evidence: Therapeutic, III.