Ultrasound-guided trigeminal nerve block and its comparison with conventional analgesics in patients undergoing faciomaxillary surgery: Randomised control trial.

BACKGROUND AND AIMS: Ultrasound (USG)-guided injection in pterygopalatine fossa is an indirect approach to block the trigeminal nerve. Trigeminal nerve block for maxillofacial surgeries may provide preemptive analgesia, reduce opioid consumption and opioid-related adverse effects.

METHODS

In this randomised, prospective double-blind study, 60 American Society of Anesthesiologists I/II patients, within the age group of 18-60 years scheduled for faciomaxillary surgery (fracture/pathological lesion of maxilla or mandible and cleft lip), were recruited. The patients were allocated in either of the two groups: group I: general anaesthesia (FENT group) and group II: general anaesthesia + trigeminal nerve (TNB group). Perioperative opioid consumption and postoperative pain scores were recorded. Any adverse effects like respiratory depression and nausea were also looked for.

RESULTS

Patients in group II required less intraoperative fentanyl top ups (1.17 ± 0.53 vs 2.70 ± 0.53) (P < 0.05). Postoperative opioid consumption was also less in this group (0.93 ± 0.69 vs 3.53 ± 0.68) (P < 0.05).

CONCLUSION

USG-guided TNB reduces perioperative opioid consumption in patients undergoing faciomaxillary surgery with better patient pain scores.