Sphenopalatine Ganglion Block in Bimaxillary Orthognathic Surgery
The Effect of Sphenopalatine Ganglion Block on Intraoperative Analgesia, Postoperative Edema, and Pain in Bimaxillary Orthognathic Surgery
Bezmialem Vakif University
50 participants
Jun 25, 2024
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to evaluate whether sphenopalatine ganglion (SPG) block helps with intraoperative pain control, reduces postoperative edema, and decreases pain in adults aged 18 to 45 undergoing bimaxillary orthognathic surgery. The main questions it aims to answer are: * Does SPG block help decrease postoperative swelling and pain compared to a sham block? * Does it improve pain control during surgery and reduce opioid use? Researchers will compare patients receiving SPG block to those receiving a sham block to determine if this technique provides better pain relief and reduces postoperative complications. Participants will: * Be 18 to 45 years old and undergo bimaxillary orthognathic surgery. * Be randomly assigned to receive either a SPG block or a sham block before surgery. * Be monitored for 1 month after surgery to assess pain levels, swelling, opioid use, and possible complications.
Eligibility
Inclusion Criteria3
- Patients with bimaxillary orthognathic surgery indication
- Patients with American Society of Anesthesiologistsscores (ASA) I-II
- Patients between the ages of 18-45
Exclusion Criteria12
- Patients with local anesthetic allergy
- Patients undergoing genioplasty
- Syndromes associated with secondary deformities in addition to jaw deformities
- Patients with a history of jaw surgery
- Patients with uncontrolled hypertension
- Patients with a history of substance abuse
- Patients with chronic pain lasting more than 3 months
- Patients using analgesic and hypnotic agents for more than 2 weeks
- Recent situations that may cause facial edema (tooth extraction, facial trauma, etc.)
- Patients with psychiatric disorders
- Patients with diabetes mellitus
- Patients with bleeding disorders
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Interventions
To perform an SPG block, the ultrasound linear probe is placed parallel to the zygomatic bone, facing anteriorly, to obtain an image that includes the ramus of the maxilla and mandible and the pterygoid process of the sphenoid bone. A 23-gauge, 50 mm needle is inserted just behind the posterior orbital rim and advanced in an antero-caudal direction over the zygomatic arch. When the needle reaches the pterygopalatine fossa at approximately 5 cm, aspiration is performed to check for blood. If no blood is seen, 4 mL of 0.5% bupivacaine is injected. The procedure is performed on both sides
To perform a Sham block, the ultrasound linear probe is placed parallel to the zygomatic bone, facing anteriorly, to obtain an image that includes the ramus of the maxilla and mandible and the pterygoid process of the sphenoid bone. A 23-gauge, 50 mm needle is inserted just behind the posterior orbital rim and advanced in an antero-caudal direction over the zygomatic arch. When the needle reaches the pterygopalatine fossa at approximately 5 cm, aspiration is performed to check for blood. If no blood is seen, 4 mL of %0,9 NaCl is injected. The procedure is performed on both sides.
Locations(1)
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NCT06933680