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To examine the effectiveness of ultrasonography-guided suprazygomatic maxillary nerve block (SZMNB) for pain relief following functional endoscopic sinus surgery.
Administration of nerve block via the ultrasound-guided suprazygomatic approach prior to the endoscopic sinus surgery drastically reduces postoperative pain by blocking nociceptive impulses and preventing sensitization.
To examine the effectiveness of ultrasonography-guided suprazygomatic maxillary nerve block (SZMNB) for pain relief following functional endoscopic sinus surgery.
A total of 48 adult individuals (18 to 65 years old) with American Society of Anesthesiologists (ASA) physical status classified as I and II, scheduled for sinus surgery, participated in this randomized controlled trial. The participants were randomly assigned to one of two groups:
The numerical rating scale (NRS) for pain scores immediately after surgery was regarded as the primary outcome. The secondary outcomes included total postoperative rescue analgesic usage over 24 hours, surgeon satisfaction ratings, postoperative hemodynamic measurements, and the incidence of complications after the surgery.
The median (interquartile range) NRS pain score in the immediate postoperative period was 0 (0-0.25) [95% confidence interval (CI): 0, 0.08] for the nerve block group, while it was 2 (1.75-3) [95% CI: 1.60, 2.40] for the control group (P < 0.001). Pain scores were considerably lower at all measured time points up to 24 hours post-surgery. No patients in the nerve block group required rescue analgesia. On the other hand, 8 patients in the control group were administered Diclofenac 75 mg given intravenously as rescue analgesia within the first hour after surgery, and 10 patients needed it within 1 to 6 hours post-surgery. Other secondary outcomes were found to be insignificant between the groups.
The ultrasound-guided nerve block offers safe and effective postoperative pain relief for patients undergoing endoscopic sinus surgery and is associated with minimal side effects.
Indian Journal of Anaesthesia
Evaluation of ultrasound-guided suprazygomatic maxillary nerve block in functional endoscopic sinus surgery for postoperative pain relief: A randomised controlled trial
Adhip Neupane et al.
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