title: Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery.
abstract: OBJECTIVE
  While infraorbital nerve blocks have demonstrated analgesic benefits for pediatric nasal and facial plastic surgery, no studies to date have explored the effect of this regional anesthetic technique on adult postoperative recovery. We designed this study to test the hypothesis that infraorbital nerve blocks combined with a standardized general anesthetic decrease the duration of recovery following outpatient nasal surgery.
  
  
  METHODS
  At a tertiary care university hospital, healthy adult subjects scheduled for outpatient nasal surgery were randomly assigned to receive bilateral infraorbital injections with either 0.5% bupivacaine (Group IOB) or normal saline (Group NS) using an intraoral technique immediately following induction of general anesthesia. All subjects underwent a standardized general anesthetic regimen and were transported to the recovery room following tracheal extubation. The primary outcome was the duration of recovery (minutes) from recovery room admission until actual discharge to home. Secondary outcomes included average and worst pain scores, nausea and vomiting, and supplemental opioid requirements.
  
  
  RESULTS
  Forty patients were enrolled. A statistically significant difference in mean [SD] recovery room duration was not observed between Groups IOB and NS (131 [61] min vs 133 [58] min, respectively; P = 0.77). Subjects in Group IOB did experience a reduction in average pain on a 0-100 mm scale (mean [95% confidence interval]) compared to Group NS (-11 [-21 to 0], P = 0.047), but no other comparison of secondary outcomes was statistically significant.
  
  
  CONCLUSIONS
  When added to a standardized general anesthetic, bilateral IOB do not decrease actual time to discharge following outpatient nasal surgery despite a beneficial effect on postoperative pain.
authors.affiliation: Department of Anesthesiology, University of California, San Diego, CA 92103-8770, USA. ermariano@ucsd.edu
authors.forename: Edward R
authors.initials: ER
authors.lastname: Mariano
authors.forename: Deborah
authors.initials: D
authors.lastname: Watson
authors.forename: Vanessa J
authors.initials: VJ
authors.lastname: Loland
authors.forename: Larry F
authors.initials: LF
authors.lastname: Chu
authors.forename: Gloria S
authors.initials: GS
authors.lastname: Cheng
authors.forename: Sachin H
authors.initials: SH
authors.lastname: Mehta
authors.forename: Rosalita C
authors.initials: RC
authors.lastname: Maldonado
authors.forename: Brian M
authors.initials: BM
authors.lastname: Ilfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D009668:Nose Diseases / Q000601:surgery*; D009915:Orbit; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010351:Patient Discharge; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine