• Emmanuel Boselli, Lionel Bouvet, Caroline Augris-Mathieu, Gérard Bégou, Nathalie Diot-Junique, Najia Rahali, Delphine Vertu-Ciolino, Cécile Gérard, Christine Pivot, François Disant, and Bernard Allaouchiche.
• Department of anaesthesiology and intensive care, Édouard-Herriot hospital, Hospices Civils de Lyon, Lyon, France; Claude-Bernard Lyon I university, university of Lyon, Lyon, France. Electronic address: emmanuel.boselli@chu-lyon.fr.
• Anaesth Crit Care Pain Med. 2016 Feb 1; 35 (1): 31-36.

IntroductionWe conducted a study to determine the efficacy of bilateral extraoral infraorbital and infratrochlear nerve blocks during outpatient rhinoseptoplasty under general anaesthesia.Patients And MethodsIn this prospective, double-blind, randomised, controlled trial, 40 adult patients undergoing outpatient rhinoseptoplasty under general anaesthesia were assigned to receive bilateral infraorbital and infratrochlear nerve blocks with either 10mL of 0.25% levobupivacaine (Group LB) or isotonic saline (control group). Patients in Group LB received 0.1mL/kg of isotonic saline as a placebo and patients in the control group received 0.1mL/kg of morphine. The primary endpoint was total perioperative morphine consumption (intraoperative and in the post-anaesthesia care unit). The secondary endpoints were pain scores, time spent in the post-anaesthesia care unit and the outpatient ward, block-related complications and patient satisfaction.ResultsThe total dose of perioperative morphine was lower in Group LB than in the control group (2.5±2.8mg versus 9.5±3.5mg, respectively, P<0.001). The mean±SD or median [IQR] times spent in the post-anaesthesia care unit (60±10min and 78±33min, respectively, P<0.03) and in the outpatient ward (210 [178-223] min versus 275 [250-300] min, respectively, P<0.001) were lower in Group LB than in the control group. There were no differences between groups for other endpoints.ConclusionBilateral extraoral infraorbital and infratrochlear nerve blocks performed with 0.25% levobupivacaine during general anaesthesia combining remifentanil and desflurane reduce the perioperative dose of morphine and the time spent in the post-anaesthesia care unit and the outpatient ward in adult patients undergoing outpatient rhinoseptoplasty.Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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