A Comparative Study between Bilateral Ultrasound-Guided Suprazygomatic Maxillary Nerve Block with or without Bilateral Nasociliary Nerve Block for Postoperative Pain Control in Nasal Surgery

Document Type : Original Article

Authors

1 Professor and Head of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Lecturer of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 MSc, Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446668

Abstract

Background: Nasal surgery is commonly associated with varying degrees of pain. The main anesthetic goal in the postoperative period is early and pain-free recovery, with return of the protective airway reflex. A range of painful side effects, including emerging agitation, self-extubation, hemorrhage, aspiration, hypoxia, and the need for reoperation, are typical after nasal surgery.         
Aim and objectives: To determine if nasal surgery patients require opioids during or after surgery for a bilateral ultra-guided suprazygomatic maxillary (US-SZM) nerve block, in conjunction with or in lieu of a nasociliary nerve block.
Subjects and methods: Al-Azhar University Hospital hosted this prospective, double-blind, randomized controlled trial from April 2023 to February 2025. Subjects in this study were undergoing elective nose surgery and had either an ASA physical status I or II.
Results: There was a significant relationship between groups A, B, and C when comparing the efficacy of first rescue analgesia. No statistically significant difference was found between groups A, B, and C with respect to the amount of fentanyl (mic.gm).
Conclusion: When comparing the groups, the time it took for the first dose of rescue analgesia was significantly different. Patients undergoing nasal surgery under general anesthesia benefit greatly from bilateral nasociliary and maxillary nerve blocks in terms of perioperative pain, opioid requires, and emerging agitation. As a result, we determined that these blocks are effective pain management techniques.
 

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