Sensory Nerve Block for Open Septorhinoplasty Surgery: A Retrospective Study

Abstract Background One of the primary concerns for patients undergoing surgery is postoperative pain control. In this study, we compared the effect of sensory nasal nerve block in two groups of patients. Objectives We hypothesized that performing a series of focused sensory nasal nerve blocks would lower opioid requirements in the post anesthesia care unit (PACU), compared to the group who did not receive the nerve block. The secondary outcome was the average pain score in PACU. Methods In this retrospective single-center study patients underwent open septorhinoplasty surgery under general anesthesia. In one group, sensory nasal nerve blocks (NB) were administered and in the control (CN) group the nerve block was not applied. The NB group (n=64) were administered 0.25% plain bupivacaine in the infraorbital, infratrochlear, supratrochlear, supraorbital, nasal sidewall, and nasal sill areas. The CN group (n=115) did not receive the nerve blocks. Results On multivariable analysis PACU opioid morphine milligram equivalents (MME) were lower in patients that received the nerve block than the patients in the CN group; -0.10 opioid MME per kg (95% Cl -0.16, -0.03, p=0.003). Additionally, on multivariable analysis the patients in the NB group had lower average pain score in PACU compared to the CN group; -1.30 (95% Cl -2.09, -0.51, p=0.001). Conclusions In open septorhinoplasty procedures, performing bilateral nerve blocks under general anesthesia prior to emergence is associated with a significant reduction in postoperative opioid consumption and average pain scores in the PACU.