title: [Inferior alveolar nerve block with ropivacaine: effect on nausea and vomiting after mandibular osteotomy].
abstract: BACKGROUND
  Our objective was to evaluate the contribution of bilateral inferior alveolar nerve block (BIANB) in patients before mandibular sagittal osteotomy for postoperative pain management, consumption of opioids, treatment of nausea and vomiting.
  
  
  METHODS
  We included 30 patients undergoing mandibular sagittal osteotomy in a prospective, randomized, double blind study. The first group of patients (n=14) underwent a standard procedure (general anesthesia with postoperative morphine treatment). The second group of patients (n=16) underwent BIANB before surgery, in addition to the standard procedure. The postsurgical management was evaluated every four hours for the first 24hours, according to the following criteria: postoperative nausea and vomiting (PONV), visual analogue scale (VAS) assessment of pain, consumption of morphine (cumulative dose) and antiemetic drugs, and need for releasing inter-maxillary blockage.
  
  
  RESULTS
  PONV was significantly less frequent in the second group (6.3 % versus 42.9 %, P=0.031). The frequency of releasing inter-maxillary blockage and the consumption of antiemetic drugs were not significantly different in the two groups. The mean VAS pain score was significantly lower in the second group (1.6 versus 0.9 avec P=0.045). There was no significant difference in cumulative morphine requirements between the two groups at 24hours.
  
  
  CONCLUSIONS
  BIANB during mandibular osteotomy increases the patient comfort by decreasing PONV and improving postsurgical analgesia.
authors.affiliation: Service de stomatologie et de chirurgie maxillofaciale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France. chatellier-a@chu-caen.fr
authors.forename: A
authors.initials: A
authors.lastname: Chatellier
authors.forename: A E
authors.initials: AE
authors.lastname: Dugué
authors.forename: C
authors.initials: C
authors.lastname: Caufourier
authors.forename: B
authors.initials: B
authors.lastname: Maksud
authors.forename: J F
authors.initials: JF
authors.lastname: Compère
authors.forename: H
authors.initials: H
authors.lastname: Bénateau
mesh_terms: D000293:Adolescent; D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000932:Antiemetics / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008334:Mandible / Q000601:surgery; D008340:Mandibular Nerve / Q000187:drug effects*; D009020:Morphine / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000209:etiology*; D011446:Prospective Studies; D000077212:Ropivacaine; D055815:Young Adult
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000932:Antiemetics; D009294:Narcotics; D009020:Morphine; D000077212:Ropivacaine