Inhibition of physiologic stress responses by regional nerve block during orthognathic surgery under hypotensive anesthesia

Mandibular nerve block can improve intraoperative inferior alveolar nerve visualization during sagittal split mandibular osteotomy

“…This hypothesis is supported by the fact that MNB may inhibit endogenous catecholamine secretion during orthognathic surgery (Mamiya et al, 1997), and improves hemodynamic stability (Noma et al, 1998). This hypothesis is not supported by our results.…”

Ultrasound-guided maxillary nerve block: an anatomical study using the suprazygomatic approach

“…The ultrasound images were easily obtained and were high quality, allowing for accurate observation of dye spread and needle movements. By ultrasound, the median [interquartile range (IQR)] distance from the skin to the greater wing of the sphenoid and to the PPF was 13 [11][12][13][14][15][16] degrees inferiorly and 15 [10][11][12][13][14][15][16][17] degrees posteriorly (Table). In one specimen, the needle entrance to the PPF was difficult to negotiate because of a small pterygopalatine fissure, and the needle was angulated more caudally (388).…”

“…Après l'injection, une dissection a été réalisée afin de déterminer la zone de diffusion du colorant. degrés en inférieur et de 15 [10][11][12][13][14][15][16][17] degrés en postérieur. La fosse ptérygo-maxillaire était teintée de manière uniforme dans le groupe 5 mL, mais de façon sporadique dans le groupe 1 mL.…”

“…[10][11][12] Regional anesthesia for orthognathic and maxillofacial surgery has been reported to reduce intraoperative stress responses and perioperative opioid consumption, providing an adjunctive anesthetic technique with an overall improved safety profile. 13,14 Numerous complications are associated with the MN block, including persistent paresthesia, hematoma formation, diplopia, transient ophthalmoplegia and ptosis, penetration of the orbit, temporal blindness, and brainstem anesthesia. [15][16][17][18] Among all types of approach, the suprazygomatic approach has been reported to have a more favourable safety profile.…”

“…Results The median [interquartile range (IQR)] distance from the skin to the PPF was 37 [36-43] mm and 47 [40-50] mm by ultrasound and rubber marker methods, respectively. The median [IQR] needle orientation was 14 degrees inferiorly and 15 [10][11][12][13][14][15][16][17] degrees posteriorly. The PPF was consistently dyed in the 5 mL group, but sporadically dyed in the 1 mL group.…”