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Effect of infraorbital nerve block under general anesthesia on consumption of isoflurane and postoperative pain in endoscopic endonasal maxillary sinus surgery.

Author(s): Higashizawa T, Koga Y

Affiliation(s): Department of Anesthesia, Sakai Hospital in Research Institute of Basic-Clinical Medicine, Kinki University, 2-7-1 Harayama-dai, Sakai 590-0132, Japan.

Publication date & source: 2001, J Anesth., 15(3):136-8.

Publication type: Clinical Trial; Randomized Controlled Trial

PURPOSE: The efficacy of infraorbital nerve block in reducing isoflurane consumption and postoperative pain was evaluated in patients undergoing endoscopic endonasal maxillary sinus surgery (ESS) under general anesthesia. METHODS: Fifty patients were randomly allocated to either the block group (n =15) or the nonblock group (n = 25). After the establishment of general anesthesia with isoflurane, nitrous oxide, and oxygen, the patients received infraorbital nerve block with 1.0 ml of either 0.5% bupivacaine (block group) or normal saline (nonblock group) administered into the soft tissue in front of the infraorbital foramen. Systolic blood pressure during anesthesia and surgery was maintained at 85-90 mmHg by adjusting the inspiratory concentration of isoflurane, and its consumption was evaluated in both groups. Pain intensity at 15 min after the end of anesthesia was also evaluated on a five-point pain scale. RESULTS: The consumption of isoflurane under a fresh gas flow of 6 l.min(-1) was 17.3 +/- 6.5 ml.kg(-1).h(-1) (mean +/- SD) in the block group and 27.4 +/- 9.4 ml.kg(-1).h(-1) in the nonblock group during surgery ( P < 0.001). Nicardipine was required during surgery less frequently in the block group than in the nonblock group ( P < 0.01). Postoperative pain intensity was lower in the block group than in the nonblock group ( P < 0.01). CONCLUSION: General anesthesia combined with infraorbital nerve block is effective in reducing the consumption of isoflurane and postoperative pain intensity in ESS.

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