Comparison of postoperative analgesia between greater palatine nerve block with local infiltration and local infiltration alone in septoplasty surgeries

<p class="abstract"><strong>Background:</strong> Post-operative pain (POP) management is an important factor for the satisfaction after any surgery to patients. The purpose of this study was to evaluate the effect in the post op pain levels by addition of greater palatine nerve block (GPNB) to the local mucosal infiltrative anaesthesia during septoplasty surgery.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 108 patients undergoing septoplasty surgery were divided into 2 groups. Group A with 52 patients and B with 56 patients. Group A received GPNB along with local infiltrative anaesthesia while group B received only the local infiltrative anaesthesia. The POP was studied in them using visual analogue score (VAS) at the 2nd, 5th and 8th post-operative hour. </p><p class="abstract"><strong>Results:</strong> The median VAS of group A at the 2nd, 5th and 8th hour were 2, 2 and 1 respectively while of the group B were 6, 6 and 5 during the same timeline assessment. The decreased POP in group A over B was statistically significant during all the assessments with (p&lt;0.001). The post-operative pain was significantly lesser with no increase in time of surgery, with negligible expenditure and no complications.</p><p class="abstract"><strong>Conclusions:</strong> Greater palatine nerve block can be utilized as an effective addition to septoplasty surgery utilizing the same drug along with local infiltration and give a simple, cost effective and safe addition for a comfortable pain free post op period for a prolonged duration.</p>

Effectiveness of the Greater Palatine Nerve Block for Anaesthetising Anterior Palate: A Prospective Study

Introduction: Local Anaesthesia (LA) is the mainstay of any routine dental extraction. Accomplishing optimum anaesthesia with least pain and anxiety to patients is a challenge. Hence, modification of technique and application of routine dental LA to enhance patient comfort is the need of the hour. In this pursuit, a prospective cohort study was carried out to evaluate the effectiveness of greater palatine nerve block as an alternative to nasopalatine nerve block in anaesthetising the anterior palatal mucosa and to achieve optimum palatal anaesthesia. Aim: The primary outcome variable is to assess the extent of the anaesthetic effect of greater palatine nerve block in maxillary anterior palatal region. Materials and Methods: A total of 100 patients scheduled for the extraction of ipsilateral anterior and posterior maxillary teeth were included in this prospective study between June 2017 to June 2019. Palatal anaesthesia for all the extractions done was achieved only with greater palatine nerve block. After an interval of five minutes, the extent of palatal anaesthesia from the posterior palatal tissue to the anterior region was evaluated for both subjective and objective symptoms. Pain on the palatal mucosa was assessed using Numerical rating scale of 0-10. Post-evaluation, depending on the proposed tooth of extraction, buccal anaesthesia was achieved with Posterior superior alveolar nerve block for posterior teeth and infraorbital nerve block for anterior teeth. Results: Of the 100 patients administered with greater palatine nerve block, it was observed that in 36 patients (36%) had effectiveness in anaesthesia till central incisor, 28 (28%) patients had effectiveness in anaesthesia till lateral incisor, 20 (20%) patients had effective in anaesthesia till the canine and 16 (16%) patients anaesthetic effects were limited to posterior teeth. Overall, 84% had varied degree of positive anterior anaesthesia with greater palatine nerve block alone. Conclusion: Greater palatine nerve block was effective in providing anaesthesia to the posterior region till the premolars, with the extended complete anaesthesia in the anterior region with similar action as the nasopalatine nerve block administered to anaesthetise the anterior palate for extraction of the anterior teeth.