Abstract
Introduction: Regional anesthesia, especially the ultrasound-guided maxillary nerve block (MNB), has become essential in maxillofacial surgery. This technique alleviates postoperative pain and reduces opioid dependency, thereby enhancing the safety profile. Objective: To evaluate the efficacy and safety of ultrasound-guided MNB in pain control, patient satisfaction, and reduction of analgesic consumption compared to other anesthetic techniques. Methodology: A systematic review was conducted following PRISMA, analyzing studies from 2018 to 2025 on the use of ultrasound-guided MNB in head and neck surgery. Results: Ultrasound-guided MNB potentially reduced the consumption of analgesics and improved postoperative pain control and patient satisfaction. Conclusion: Ultrasound-guided MNB is an effective and safe technique for managing postoperative pain in maxillofacial surgery. Its implementation reduces opioid use, enhances patient experience, and is well tolerated.
References
Echaniz G, Chan V, Maynes JT, Jozaghi Y, Agur A. Ultrasound-guided maxillary nerve block: an anatomical study using the suprazygomatic approach. Can J Anesth/J Can Anesth. 1 de febrero de 2020;67(2):186-93. Disponible en: https://doi.org/10.1007/s12630-019-01481-x
Molins G, Valls-Ontañón A, De Nadal M, Hernández-Alfaro F. Ultrasound-Guided Suprazygomatic Maxillary Nerve Block Is Effective in Reducing Postoperative Opioid Use Following Bimaxillary Osteotomy. Journal of Oral and Maxillofacial Surgery. abril de 2024;82(4):412-21. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0278239123013502
Kumita S, Murouchi T, Arakawa J. Ultrasound-guided maxillary and inferior alveolar nerve blocks for postoperative analgesia in gnathoplasty. Asian Journal of Anesthesiology. 1 de diciembre de 2017;55(4):89-90. Disponible en: https://www.sciencedirect.com/science/article/pii/S1875459716301114
Cao Z, Zhang K, Hu L, Pan J. Application of ultrasound guidance in the oral and maxillofacial nerve block. PeerJ. 26 de noviembre de 2021;9:e12543. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628623/
Kojima Y, Murouchi T, Okayama N, Asano K, Akiba M, Hamasaki J. Postoperative complications of ultrasound-guided inferior alveolar nerve and maxillary nerve blocks: a retrospective study. JA Clinical Reports. 16 de junio de 2022;8(1):42. Disponible en: https://doi.org/10.1186/s40981-022-00533-4
Yamaguchi A, Kojima Y, Hirabayashi K. Ultrasound-Guided Maxillary Nerve Block and Superficial Cervical Plexus Block During Surgery for Maxillary Malignancy: A Case Report. Anesthesia Progress. 2023;70(2):88-90. Disponible en: https://anesthesiaprogress.kglmeridian.com/view/journals/anpr/70/2/article-p88.xml
Martinus M, Mihaljevic S, Reiner K, Verzak Z, Panic MK, Strahija A, et al. Analgesic effect of ultrasound-guided extraoral mandibular nerve block compared to intraoral conductive block of the inferior alveolar nerve after lower third molar alveolectomy: a clinical prospective study. BMC Oral Health. 4 de septiembre de 2024;24(1):1041. Disponible en: https://doi.org/10.1186/s12903-024-04787-5
Ahmed MB, Zaghloul A, Maarouf A, Maarouf MM, Elshafie M. Ultrasound Guided Maxillary Nerve Block for Perioperative Pain Management for Patients Undergoing Endoscopic Sinus Surgery: Randomized Control Trial [Internet]. Anesthesiology and Pain Medicine; 2024 . Report No.: 14. Disponible en: https://brieflands.com/articles/aapm-144074#abstract
Mansour RF, and Abdelghany MS. Ultrasound-guided suprazygomatic maxillary nerve block in cleft palate surgery: The efficacy of adding dexmedetomidine to bupivacaine. Egyptian Journal of Anaesthesia. 1 de enero de 2021;37(1):329-36. Disponible en: https://doi.org/10.1080/11101849.2021.1953832
Esquerré T, Mure M, Minville V, Prevost A, Lauwers F, Ferré F. Bilateral ultrasound-guided maxillary and mandibular combined nerves block reduces morphine consumption after double-jaw orthognathic surgery: a randomized controlled trial. Reg Anesth Pain Med [Internet]. 2 de mayo de 2024; Disponible en: https://rapm.bmj.com/content/early/2024/07/08/rapm-2024-105497
Afandy ME, Abd Elghafar MS, Shoukr TG, El Mourad MB. Efficacy of ultrasound-guided suprazygomatic maxillary nerve block on emergence agitation and postoperative analgesia after septorhinoplasty: A prospective randomized trial. J Anaesthesiol Clin Pharmacol. 2024;40(4):679-85. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694882/
Chen MK, Zhao L, Luo W, Luo K, Lin J, Ji Y. Effectiveness of Low-Volume Versus High-Volume Ropivacaine for Ultrasound-Guided Maxillary Nerve Block in Double-Jaw Surgery: A Randomized Non-inferiority Trial. Aesthetic Plast Surg. 2025;49(5):1217-26. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965159/
Neupane A, Jain D, Arora S, Gandhi K, Singla V, Goel N, et al. Evaluation of ultrasound-guided suprazygomatic maxillary nerve block in functional endoscopic sinus surgery for postoperative pain relief: A randomised controlled trial. Indian J Anaesth. agosto de 2024;68(8):706-11. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338370/
Sumalatha GB, Patel S, Yadav H, Dodawad R. Efficacy of Nalbuphine as An Adjunct to 0.5% Bupivacaine in Ultrasound- Guided Suprazygomatic Maxillary Nerve Block in Patients Undergoing Nasal and Maxillofacial Surgery – A Randomized Clinical Comparative Study. Sri Lankan J Anaesthesiol. 22 de enero de 2025;33(01):71-8. Disponible en:
Abu Elyazed MM, and Mostafa SF. Bilateral suprazygomatic maxillary nerve block versus palatal block for cleft palate repair in children: A randomized controlled trial. Egyptian Journal of Anaesthesia. 1 de julio de 2018;34(3):83-8. Disponible en: https://account.slja.sljol.info/index.php/sljo-j-slja/article/view/9415
Ramasamy AM, Sukumar SK, Srinivasan P, Kumar Kodali VR, Manickam A, Parameswari A, et al. A Comparative Study on the Analgesic Efficacy of Bilateral Suprazygomatic Maxillary Nerve Block Under Ultrasound Guidance with 0.25% Bupivacaine and 0.25% Bupivacaine with Dexmedetomidine in Paediatric Patients Undergoing Cleft Palate Repair - A Randomized Prospective Double Blinded Study. JARSS. 28 de enero de 2022;30(1):1-8. Disponible en: https://jag.journalagent.com/anestezi/pdfs/JARSS_30_1_1_8.pdf

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