Preoperative Ultrasound-Guided Trigeminal Nerve Block in Orthognathic Surgery: A Prospective Study About Its Efficacy of Intraoperative Anesthetic Dosage and Postoperative Analgesia

Purpose Ultrasound-guided trigeminal nerve block is rarely used in orthognathic surgery, and its impact of postoperative analgesia and the auxiliary effect on hypotensive anesthesia have not been fully reported. The purpose of this study is to measure the efficacy of ultrasound-guided trigeminal nerve block on intraoperative anesthetic dosage and postoperative analgesia. Patients and Methods In this single-blind, prospective, controlled trial, all patients were randomly assigned to 2 groups (n = 21/group): GEA group (general anesthesia) and TNB group (ultrasound-guided trigeminal nerve block [UGTNB] with general anesthesia). The primary variable was postoperative pain (visual analog scale scores, VAS scores) at postoperative 2, 4, 6, 12, and 24 hours. Satisfaction with postoperative pain management during postoperative 24 hours; the number of patients with moderate-to-severe pain (VAS score: >3) at postoperative 2, 4, 6, 12, 24 hours; and the consumption of opioids and nicardipine intraoperatively, etc. were secondary variables. Data were analyzed using the unpaired t, χ2, and Wilcoxon nonparametric tests. Results In this study, 40 patients at the Peking University School and Hospital of Stomatology between January 2019 to March 2019 were included with a mean age of 24.13 ± 5.07 for statistical analysis and 37.5% were male. Compared to GEA group, the TNB group had a significantly lower VAS scores at postoperative 6 hours and 12 hours, which were 2[0,2] and 0[0,2], respectively. Furthermore, patients in TNB group were more satisfied with pain management at postoperative 24 hours than patients in GEA group (5[4,5] vs 4[3,5]; P = .03). Statistically less amount of opioids and nicardipine in TNB group were used intraoperatively (P < .01). Conclusion UGTNB use in orthognathic surgery may improve analgesia in the 24 hours after the operation, additionally, facilitate hypotensive anesthesia with fewer agents and fewer adverse effects postoperatively. Ultrasound-guided trigeminal nerve block is rarely used in orthognathic surgery, and its impact of postoperative analgesia and the auxiliary effect on hypotensive anesthesia have not been fully reported. The purpose of this study is to measure the efficacy of ultrasound-guided trigeminal nerve block on intraoperative anesthetic dosage and postoperative analgesia. In this single-blind, prospective, controlled trial, all patients were randomly assigned to 2 groups (n = 21/group): GEA group (general anesthesia) and TNB group (ultrasound-guided trigeminal nerve block [UGTNB] with general anesthesia). The primary variable was postoperative pain (visual analog scale scores, VAS scores) at postoperative 2, 4, 6, 12, and 24 hours. Satisfaction with postoperative pain management during postoperative 24 hours; the number of patients with moderate-to-severe pain (VAS score: >3) at postoperative 2, 4, 6, 12, 24 hours; and the consumption of opioids and nicardipine intraoperatively, etc. were secondary variables. Data were analyzed using the unpaired t, χ2, and Wilcoxon nonparametric tests. In this study, 40 patients at the Peking University School and Hospital of Stomatology between January 2019 to March 2019 were included with a mean age of 24.13 ± 5.07 for statistical analysis and 37.5% were male. Compared to GEA group, the TNB group had a significantly lower VAS scores at postoperative 6 hours and 12 hours, which were 2[0,2] and 0[0,2], respectively. Furthermore, patients in TNB group were more satisfied with pain management at postoperative 24 hours than patients in GEA group (5[4,5] vs 4[3,5]; P = .03). Statistically less amount of opioids and nicardipine in TNB group were used intraoperatively (P < .01). UGTNB use in orthognathic surgery may improve analgesia in the 24 hours after the operation, additionally, facilitate hypotensive anesthesia with fewer agents and fewer adverse effects postoperatively.