Two versus five bilateral local anesthetic injections for submucosal resection: a randomized double-blind clinical trial

Background Submucous resection (SMR) is performed under general anesthesia, local anesthesia, or a combination of both. The combination was associated with less postoperative pain and shorter hospital stay. The purpose of this clinical trial was to compare the effectiveness of two versus five bilateral local anesthetic injections in terms of postoperative pain relief at 24 h postoperatively. Patients and methods This was a prospective, randomized, double-blind clinical trial conducted at a tertiary care center between May 2015 and December 2016. Patients aged between 15 and 63 years scheduled for elective SMR of the nasal septum were included. Eligible patients received general anesthesia and were randomly assigned to receive either two or five bilateral local anesthetic injections. The primary outcome was pain assessed by the Numeric Rating Scale. Other outcomes were hemodynamic stability, analgesic consumption, nausea and vomiting, as well as patient’s and surgeon’s satisfaction. Results A total of 120 patients were included in the study and were divided equally into the two groups. Both groups were similar in terms of age, height, weight, surgery duration, and hemodynamic characteristics. There was no significant difference for both groups in pain scores at 24 h (1.53±1.25 vs. 2.07±1.82, P=0.069 for two vs. five injections, respectively) and over the 10 postoperative days. Similarly, the number of patients who consumed analgesics was similar between the two groups. Conclusion The present study revealed that two bilateral local anesthetic injections at the suprazygomatic and infraorbital areas could be an alternative to five injections in patients undergoing SMR.