Ultrasound Guided Maxillary Nerve Block for Perioperative Pain Management for Patients Undergoing Endoscopic Sinus...

Area of Science:

• Anesthesiology
• Otolaryngology
• Pain Management

Background:

• Effective perioperative pain management is crucial for successful functional endoscopic sinus surgery (FESS).
• Optimizing analgesia involves prolonged postoperative pain relief while minimizing opioid use and side effects.

Purpose of the Study:

• To assess the impact of bilateral ultrasound-guided suprazygomatic maxillary nerve block (MNB) on postoperative pain following FESS.
• To compare the efficacy of MNB with traditional multimodal analgesia in FESS patients.

Main Methods:

• Patients undergoing FESS were randomized into two groups: MNB group (n=30) and control group (n=30).
• The MNB group received a bilateral ultrasound-guided suprazygomatic maxillary nerve block, while the control group received multimodal analgesia including opioids.
• Pain scores, rescue analgesia requirements, postoperative complications (PONV, headache), and patient satisfaction were recorded over 48 hours.

Main Results:

• The MNB group reported significantly lower pain scores compared to the control group (P < 0.001), particularly during hemostatic agent removal.
• Total rescue analgesia consumption was significantly lower in the MNB group (P < 0.001).
• Fewer postoperative complications (nausea, vomiting, headache) were observed in the MNB group (76.7%) versus the control group (40%), with higher patient satisfaction (P < 0.001).

Conclusions:

• Bilateral ultrasound-guided suprazygomatic MNB is a safe and effective technique for managing FESS postoperative pain.
• MNB reduces analgesic consumption, postoperative morbidities, and enhances patient satisfaction.
• This nerve block offers a promising alternative to traditional opioid-based analgesia in FESS.