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Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery

  • Mariano, Edward R.1
  • Watson, Deborah2
  • Loland, Vanessa J.1
  • Chu, Larry F.3
  • Cheng, Gloria S.1
  • Mehta, Sachin H.4
  • Maldonado, Rosalita C.1
  • Ilfeld, Brian M.1
  • 1 University of California, Department of Anesthesiology, San Diego, CA, 92103-8770, USA , San Diego (United States)
  • 2 University of California, Department of Surgery, Division of Otolaryngology/Head and Neck Surgery, San Diego, CA, USA , San Diego (United States)
  • 3 Stanford University, Department of Anesthesiology, Palo Alto, CA, USA , Palo Alto (United States)
  • 4 University of Virginia, Department of Anesthesiology, Charlottesville, VA, USA , Charlottesville (United States)
Published Article
Canadian Journal of Anesthesia/Journal canadien d anesthésie
Publication Date
May 28, 2009
DOI: 10.1007/s12630-009-9119-5
Springer Nature


PurposeWhile infraorbital nerve blocks have demonstrated analgesic benefits for pediatric nasal and facial plastic surgery, no studies to date have explored the effect of this regional anesthetic technique on adult postoperative recovery. We designed this study to test the hypothesis that infraorbital nerve blocks combined with a standardized general anesthetic decrease the duration of recovery following outpatient nasal surgery.MethodsAt a tertiary care university hospital, healthy adult subjects scheduled for outpatient nasal surgery were randomly assigned to receive bilateral infraorbital injections with either 0.5% bupivacaine (Group IOB) or normal saline (Group NS) using an intraoral technique immediately following induction of general anesthesia. All subjects underwent a standardized general anesthetic regimen and were transported to the recovery room following tracheal extubation. The primary outcome was the duration of recovery (minutes) from recovery room admission until actual discharge to home. Secondary outcomes included average and worst pain scores, nausea and vomiting, and supplemental opioid requirements.ResultsForty patients were enrolled. A statistically significant difference in mean [SD] recovery room duration was not observed between Groups IOB and NS (131 [61] min vs 133 [58] min, respectively; P = 0.77). Subjects in Group IOB did experience a reduction in average pain on a 0–100 mm scale (mean [95% confidence interval]) compared to Group NS (−11 [−21 to 0], P = 0.047), but no other comparison of secondary outcomes was statistically significant.ConclusionsWhen added to a standardized general anesthetic, bilateral IOB do not decrease actual time to discharge following outpatient nasal surgery despite a beneficial effect on postoperative pain.

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