Infraorbital versus sphenopalatine ganglion block for patient-reported recovery after septorhinoplasty: A randomized controlled trial
In brief
Infraorbital nerve block raised recovery scores by 12.5 points after septorhinoplasty
In a randomized trial of 89 adults, infraorbital nerve block produced a 12.5-point higher recovery score at 24 hours than sphenopalatine ganglion block, exceeding the threshold for a clinically important difference. Fewer patients needed rescue pain medicine, while nausea, anesthetic use and recovery-room time were similar; secondary findings remain hypothesis-generating.
- Journal
- Journal of clinical anesthesia (Q1)
- Published
- 28 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ömer Keklicek, Mustafa Aydemir, Turgay Atay, Muhammed Nezih Koç, Esra Göğer, Mahmut Sami Tutar, et al.
- PMID
- 42950360
- DOI
- 10.1016/j.jclinane.2026.112354
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (paper of the day, 29 October 2026): Randomized comparison of regional blocks and postoperative recovery
Abstract
STUDY OBJECTIVE: To compare ultrasound-guided infraorbital nerve block with transnasal sphenopalatine ganglion block on recovery quality 24 h after septorhinoplasty. DESIGN: Prospective, randomized, patient- and assessor-blinded, parallel-group trial. SETTING: Tertiary training hospital; operating room and postoperative ward. PATIENTS: Ninety adults aged 18 to 65 years, ASA physical status I or II, undergoing elective septorhinoplasty; 89 were analyzed. INTERVENTIONS: After induction of general anesthesia, patients received bilateral transnasal sphenopalatine ganglion block (SPG group) or bilateral ultrasound-guided infraorbital nerve block (IO group), 2 mL of 0.5% bupivacaine per side. Surgical infiltration and multimodal analgesia were identical in both groups. MEASUREMENTS: The primary outcome was the total Quality of Recovery-15 (QoR-15) score at 24 h. Secondary outcomes were QoR-15 domains, visual analog scale pain scores, rescue morphine, nausea and vomiting, anesthetic consumption, emergence agitation, edema, ecchymosis and recovery room stay. MAIN RESULTS: Total QoR-15 at 24 h was higher in the IO group (129.1 ± 9.4 versus 116.6 ± 11.7; mean difference 12.5 points, 95% CI 8.01 to 17.01; P = 0.001), above the prespecified minimal clinically important difference of 8. More IO patients crossed the acceptable symptom state threshold of 118 (86.4% versus 35.6%; P < 0.001). Pain scores were lower at every time point and fewer IO patients needed rescue analgesia (11.4% versus 53.3%; P = 0.001). Nausea and vomiting, anesthetic consumption and recovery room stay did not differ. CONCLUSIONS: Infraorbital nerve block gave better 24 h patient-reported recovery than sphenopalatine ganglion block after septorhinoplasty. Secondary findings are hypothesis-generating. TRIAL REGISTRATION: ClinicalTrials.govNCT06929429.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.