An observational study in Dento Facial Dysmorphism, sponsored by Hospices Civils de Lyon. Completed at 1 site in France. Per ClinicalTrials.gov, last updated 2017-10-03.
Sponsored by Hospices Civils de Lyon · Observational
Background and Objectives: Double-jaw surgery is one of the most painful oral surgery, requiring multimodal analgesia including controlled morphine pump and its secondary effects. The aim of this study was to evaluate the effectiveness of face block (mandibulary and maxillary block analgesia) on the first 24 hours on morphine consumption in patients admitted for double jaw surgery.
Methods: Patients undergoing double-jaw surgery between January 2015 and May 2017 were enrolled. Patients were separated into 2 groups: patients receiving maxillary-mandibulary nerve block and those no receiving it. The primary endpoint was the morphine consumption within 24 hours post-surgery. Secondary endpoints were the intra-operative remifentanil consumption, incidence of postoperative nausea and vomiting at 24 hours, morphine consumption in recovery room, length of stay in hospital.
Male and female who underwent double jaw surgery
Exclusion Criteria:
Patients who underwent maxillary and mandibulary block before surgery
Procedure: Maxillary and mandibular blocks · Procedure: General anesthesia
Patients who did not undergo maxillary and mandibulary block before surgery.
Procedure: General anesthesia
A Pajunk SonoPlex Stim needle 22G x 55 mm was used. For maxillary nerve block, needle was introduced next to the angle of the orbitae and the zygomatic ridge. The needle was sank until coming into contact of the temporal bone. It was then orientated to the controlateral nostril and sank of 1 cm. For mandibular block, needle was introduced in the pterygoid fossa under and perpendicularly to the zygomatic arch, and sank until the pterygoid process. The needle was then orientated towards controlateral orbitae and sank with neurostimulation. After a motor response at 0.6 milliampere (mA) and the disappearance of contraction at 0.3 mA, local mixture was injected. The mixing of local anesthesia was made of ropivacaine 5 mg/mL and clonidine 30 µg. Five mL were injected in every block for a total of 20 mL.
Anesthesia was standardized and provided using intravenous administration of propofol and remifentanil. Patients were mechanically ventilated with a mixture of air (50/50), and desflurane or sevoflurane, or Target-controlled infusion (TCI) propofol. One to 5 mg/kg of methyl-prednisolone were administered to reduce inflammatory response.
Cumulative morphine consumption within 24 hours post-surgery
Cumulative morphine consumption measured using patient controlled analgesia (PCA-pump).
Time frame: 24 hours
Peroperative remifentanil consumption
Remifentanil consumption in µg.kg-1 during surgery
Time frame: End of surgery (2 hours in average)
Cumulative morphine consumption within 12 hours post-surgery
Cumulative morphine consumption measured using patient controlled analgesia (PCA-pump).
Time frame: 12 hours
Cumulative morphine consumption within 48 hours post-surgery
Cumulative morphine consumption measured using patient controlled analgesia (PCA-pump).
Time frame: 48 hours
Hospital length of stay
Delay between hospitalization date and date of hospital discharge
Time frame: Up to hospital discharge (5 days in average)
Plan to share: No
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Hospices Civils de Lyon