{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T04:14:45Z","timestamp":1743826485603,"version":"3.40.3"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100020756","name":"West China School of Stomatology, Sichuan University","doi-asserted-by":"publisher","award":["LCYJ-2023-YF-2"],"award-info":[{"award-number":["LCYJ-2023-YF-2"]}],"id":[{"id":"10.13039\/100020756","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aesth Plast Surg"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Ultrasound-guided maxillary nerve block (UGMNB) is applied in oral and maxillofacial surgery to improve perioperative analgesia, decrease the risk of postoperative nausea and vomiting, and enhance recovery. However, the optimum volume of ropivacaine used for UGMNB is undetermined. Thus, it was hypothesized that in patients undergoing double-jaw surgery, low- and high-volume ropivacaine reduces perioperative pain with similar efficacy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Adults undergoing double-jaw surgery were enrolled in a randomized non-inferiority trial to receive a bilateral single-injection UGMNB with 2 mL (low-volume [LV] group) or 5 mL (high-volume [HV] group) of 0.375% ropivacaine on each side. A visual analog scale (VAS) score for maxillary pain at 2 h postoperatively was taken as the primary outcome. VAS score for maxillary and mandibular pain at 2, 4, 6, 8, 12, 24, and 48 h postoperatively, hemodynamic changes intraoperatively, consumption of intraoperative opioids and sedatives, vasoactive medication use, extubation time, postoperative rescue analgesia, time to the first analgesia, postoperative nausea and vomiting and UGMNB-related complications within 48 h post-surgery were assessed as the secondary outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Sixty-four adults were included. The maxillary pain score in the LV group was not inferior to that in the HV group at 2 h postoperatively, with a non-inferiority margin of 1 (mean difference \u2212\u00a00.1; 95% confidence interval [CI] \u2212\u00a00.6 to 0.8, <jats:italic>P\u00a0<\/jats:italic>= 0.414 for non-inferiority). Maxillary and mandibular pain demonstrated no difference in the measured times between groups. The incidence of postoperative nausea was significantly higher in the LV group than that in the HV group at 6\u201324 h (12 (37.5%) vs. 5 (15.6%), <jats:italic>P\u00a0<\/jats:italic>=\u00a00.048). Moreover, no differences in intraoperative hemodynamic parameters, medications during anesthesia, time to extubation, rescue analgesia, time to the first analgesia, and postoperative vomiting were observed. Only one patient in the LV group was observed to have maxillary nerve block-related complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>To conclude, the efficacy of UGMNB with 2 mL of 0.375% ropivacaine has the same efficacy as the 5 mL drug in reducing perioperative pain in patients undergoing double-jaw surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence I<\/jats:title>\n            <jats:p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.springer.com\/00266\" ext-link-type=\"uri\">www.springer.com\/00266<\/jats:ext-link>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00266-025-04671-9","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T18:00:16Z","timestamp":1737050416000},"page":"1217-1226","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Low-Volume Versus High-Volume Ropivacaine for Ultrasound-Guided Maxillary Nerve Block in Double-Jaw Surgery: A Randomized Non-inferiority Trial"],"prefix":"10.1007","volume":"49","author":[{"given":"Ming-Kai","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Ji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"issue":"7","key":"4671_CR1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.bjoms.2022.03.013","volume":"60","author":"A Alyahya","year":"2022","unstructured":"Alyahya A, Aldubayan A, Swennen GRJ, Al-Moraissi E. Effectiveness of different protocols to reduce postoperative pain following orthognathic surgery: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2022;60(7):e1\u201310.","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"11","key":"4671_CR2","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1016\/j.joms.2018.05.014","volume":"76","author":"A Mobini","year":"2018","unstructured":"Mobini A, Mehra P, Chigurupati R. Postoperative pain and opioid analgesic requirements after orthognathic surgery. J Oral Maxillofac Surg. 2018;76(11):2285\u201395.","journal-title":"J Oral Maxillofac Surg"},{"issue":"4","key":"4671_CR3","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/BF03043555","volume":"1","author":"B Niederhagen","year":"1997","unstructured":"Niederhagen B, Braumann B, Dierke-Dzierzon C, Albrecht S. Postoperative pain after interventions in the area of the mouth-jaw-face. Mund Kiefer Gesichtschir. 1997;1(4):229\u201334.","journal-title":"Mund Kiefer Gesichtschir"},{"issue":"2","key":"4671_CR4","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ijom.2018.07.013","volume":"48","author":"N Al-Hadi","year":"2019","unstructured":"Al-Hadi N, Chegini S, Klontzas ME, McKenny J, Heliotis M. Patient expectations and satisfaction following orthognathic surgery. Int J Oral Maxillofac Surg. 2019;48(2):211\u20136.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"10","key":"4671_CR5","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.ijom.2008.07.005","volume":"37","author":"C Phillips","year":"2008","unstructured":"Phillips C, Blakey G. Short-term recovery after orthognathic surgery: a medical daily diary approach. Int J Oral Maxillofac Surg. 2008;37(10):892\u20136.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"21","key":"4671_CR6","doi-asserted-by":"crossref","first-page":"11253","DOI":"10.3390\/ijerph182111253","volume":"18","author":"Y-S Huang","year":"2021","unstructured":"Huang Y-S, Chin W-C, Yao C-F, Chen Y-A, Tang I, Chen Y-R, et al. Sleep, distressed appearance, and quality of life relate to satisfaction with orthognathic surgery. Int J Environ Res Public Health. 2021;18(21):11253.","journal-title":"Int J Environ Res Public Health"},{"issue":"9 Suppl","key":"4671_CR7","first-page":"6S","volume":"32","author":"G Oderda","year":"2012","unstructured":"Oderda G. Challenges in the management of acute postsurgical pain. Pharmacotherapy. 2012;32(9 Suppl):6S-11S.","journal-title":"Pharmacotherapy"},{"issue":"3","key":"4671_CR8","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.joms.2023.12.008","volume":"82","author":"SO Ya\u015fl\u0131","year":"2024","unstructured":"Ya\u015fl\u0131 SO, Canpolat DG, Dogruel F, Demirba\u015f AE. Is Postoperative pain associated with nausea and vomiting following orthognathic surgery? J Oral Maxillofac Surg. 2024;82(3):279\u201387.","journal-title":"J Oral Maxillofac Surg"},{"issue":"10180","key":"4671_CR9","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/S0140-6736(19)30352-6","volume":"393","author":"P Glare","year":"2019","unstructured":"Glare P, Aubrey KR, Myles PS. Transition from acute to chronic pain after surgery. Lancet. 2019;393(10180):1537\u201346.","journal-title":"Lancet"},{"key":"4671_CR10","doi-asserted-by":"crossref","first-page":"7306133","DOI":"10.1155\/2023\/7306133","volume":"2023","author":"Y Oono","year":"2023","unstructured":"Oono Y, Takagi S, Arendt-Nielsen L, Kohase H. Perioperative nerve blockade reduces acute postoperative pain after orthognathic surgery. Pain Res Manag. 2023;2023:7306133.","journal-title":"Pain Res Manag"},{"issue":"3","key":"4671_CR11","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.bpa.2019.07.016","volume":"33","author":"GP Joshi","year":"2019","unstructured":"Joshi GP, Kehlet H. Postoperative pain management in the era of ERAS: an overview. Best Pract Res Clin Anaesthesiol. 2019;33(3):259\u201367.","journal-title":"Best Pract Res Clin Anaesthesiol"},{"issue":"4","key":"4671_CR12","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1097\/ALN.0b013e31826d3dfc","volume":"118","author":"A Nader","year":"2013","unstructured":"Nader A, Schittek H, Kendall MC. Lateral pterygoid muscle and maxillary artery are key anatomical landmarks for ultrasound-guided trigeminal nerve block. Anesthesiology. 2013;118(4):957.","journal-title":"Anesthesiology"},{"issue":"5","key":"4671_CR13","first-page":"E537","volume":"16","author":"A Nader","year":"2013","unstructured":"Nader A, Kendall MC, De Oliveria GS, Chen JQ, Vanderby B, Rosenow JM, et al. Ultrasound-guided trigeminal nerve block via the pterygopalatine fossa: an effective treatment for trigeminal neuralgia and atypical facial pain. Pain Physician. 2013;16(5):E537\u201345.","journal-title":"Pain Physician"},{"key":"4671_CR14","doi-asserted-by":"crossref","first-page":"110240","DOI":"10.1016\/j.jclinane.2021.110240","volume":"71","author":"L Smith","year":"2021","unstructured":"Smith L, Balakrishnan K, Pan S, Tsui BCH. Suprazygomatic maxillary (SZM) nerve blocks for perioperative pain control in pediatric tonsillectomy and adenoidectomy. J Clin Anesth. 2021;71:110240.","journal-title":"J Clin Anesth"},{"issue":"11","key":"4671_CR15","doi-asserted-by":"crossref","first-page":"871","DOI":"10.4103\/ija.IJA_256_18","volume":"62","author":"A Kumar","year":"2018","unstructured":"Kumar A, Sinha C, Kumar A, Kumari P, Mukul SK. Ultrasound-guided trigeminal nerve block and its comparison with conventional analgesics in patients undergoing faciomaxillary surgery: Randomised control trial. Indian J Anaesth. 2018;62(11):871\u20135.","journal-title":"Indian J Anaesth"},{"issue":"4","key":"4671_CR16","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.joms.2023.12.018","volume":"82","author":"G Molins","year":"2024","unstructured":"Molins G, Valls-Onta\u00f1\u00f3n A, De Nadal M, Hern\u00e1ndez-Alfaro F. Ultrasound-guided suprazygomatic maxillary nerve block is effective in reducing postoperative opioid use following bimaxillary osteotomy. J Oral Maxillofac Surg. 2024;82(4):412\u201321.","journal-title":"J Oral Maxillofac Surg"},{"issue":"10","key":"4671_CR17","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1016\/j.joms.2021.04.011","volume":"79","author":"X Wang","year":"2021","unstructured":"Wang X, Feng Y, Yang X, Li Z, Zhou D. Preoperative ultrasound-guided trigeminal nerve block in orthognathic surgery: a prospective study about its efficacy of intraoperative anesthetic dosage and postoperative analgesia. J Oral Maxillofac Surg. 2021;79(10):2042\u201350.","journal-title":"J Oral Maxillofac Surg"},{"issue":"1","key":"4671_CR18","doi-asserted-by":"crossref","first-page":"4865","DOI":"10.15419\/bmrat.v9i1.723","volume":"9","author":"MQ Pham","year":"2022","unstructured":"Pham MQ, Nguyen DTB, Nguyen AX, Tran TTP. Pain relief after maxillofacial surgery: efficacy in patients undergoing ultrasound-guided trigeminal nerve block-a randomized controlled trial. Biomed Res Therapy. 2022;9(1):4865\u201372.","journal-title":"Biomed Res Therapy"},{"issue":"2","key":"4671_CR19","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s12630-019-01481-x","volume":"67","author":"G Echaniz","year":"2020","unstructured":"Echaniz G, Chan V, Maynes JT, Jozaghi Y, Agur A. Ultrasound-guided maxillary nerve block: an anatomical study using the suprazygomatic approach. Can J Anaesth. 2020;67(2):186\u201393.","journal-title":"Can J Anaesth"},{"issue":"4","key":"4671_CR20","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1136\/rapm-2019-100569","volume":"45","author":"A Anugerah","year":"2020","unstructured":"Anugerah A, Nguyen K, Nader A. Technical considerations for approaches to the ultrasound-guided maxillary nerve block via the pterygopalatine fossa: a literature review. Reg Anesth Pain Med. 2020;45(4):301\u20135.","journal-title":"Reg Anesth Pain Med"},{"issue":"12","key":"4671_CR21","first-page":"1028","volume":"45","author":"X Qin","year":"2020","unstructured":"Qin X, Xie X. Ultrasound-guided maxillary nerve block via the pterygopalatine fossa: maxillary artery is the key. Reg Anesth Pain Med. 2020;45(12):1028\u20139.","journal-title":"Reg Anesth Pain Med"},{"issue":"2","key":"4671_CR22","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1213\/ANE.0000000000004833","volume":"131","author":"TJ Gan","year":"2020","unstructured":"Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411\u201348.","journal-title":"Anesth Analg"},{"issue":"10","key":"4671_CR23","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1016\/j.pain.2011.07.005","volume":"152","author":"MA Ferreira-Valente","year":"2011","unstructured":"Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399\u2013404.","journal-title":"Pain"},{"issue":"5","key":"4671_CR24","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1093\/bja\/aes325","volume":"109","author":"GS De Oliveira","year":"2012","unstructured":"De Oliveira GS, Castro-Alves LJ, Chang R, Yaghmour E, McCarthy RJ. Systemic metoclopramide to prevent postoperative nausea and vomiting: a meta-analysis without Fujii\u2019s studies. Br J Anaesth. 2012;109(5):688\u201397.","journal-title":"Br J Anaesth"},{"issue":"12","key":"4671_CR25","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1136\/rapm-2020-101670","volume":"45","author":"F Mu\u00f1oz-Leyva","year":"2020","unstructured":"Mu\u00f1oz-Leyva F, El-Boghdadly K, Chan V. Is the minimal clinically important difference (MCID) in acute pain a good measure of analgesic efficacy in regional anesthesia? Reg Anesth Pain Med. 2020;45(12):1000\u20135.","journal-title":"Reg Anesth Pain Med"},{"issue":"3","key":"4671_CR26","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.1016\/j.oooo.2015.10.023","volume":"121","author":"C Alamanos","year":"2016","unstructured":"Alamanos C, Raab P, Gamulescu A, Behr M. Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;121(3):e39\u201350.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"8","key":"4671_CR27","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1093\/pm\/pnac007","volume":"23","author":"CR Smith","year":"2022","unstructured":"Smith CR, Dickinson KJ, Carrazana G, Beyer A, Spana JC, Teixeira FJP, et al. Ultrasound-guided suprazygomatic nerve blocks to the pterygopalatine fossa: a safe procedure. Pain Med. 2022;23(8):1366\u201375.","journal-title":"Pain Med"},{"key":"4671_CR28","doi-asserted-by":"crossref","first-page":"481","DOI":"10.2147\/JPR.S295211","volume":"14","author":"M Kim","year":"2021","unstructured":"Kim M, Oh Y, Kim J. Diplopia after maxillary nerve block through the lateral infrazygomatic approach: a case report and literature review. J Pain Res. 2021;14:481\u20135.","journal-title":"J Pain Res"},{"issue":"2","key":"4671_CR29","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1586\/14737175.4.2.165","volume":"4","author":"AS Dalpiaz","year":"2004","unstructured":"Dalpiaz AS, Peterson D. Parecoxib: a shift in pain management? Expert Rev Neurother. 2004;4(2):165\u201377.","journal-title":"Expert Rev Neurother"},{"issue":"4","key":"4671_CR30","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.bjoms.2021.09.003","volume":"60","author":"A Oliveira De Jesus","year":"2022","unstructured":"Oliveira De Jesus A, Lacerda de Toledo G, de Oliveira M, Chiavaioli G, Guimar\u00e3es HN, de Abreu M, Alves Mesquita R, Bruno Figueiredo Amaral M. Efficacy of gastric aspiration to reduce postoperative vomiting after orthognathic surgery: double-blind randomised clinical trial. Br J Oral Maxillofac Surg. 2022;60(4):493\u20138.","journal-title":"Br J Oral Maxillofac Surg"},{"issue":"10","key":"4671_CR31","first-page":"3491","volume":"7","author":"X Yin","year":"2014","unstructured":"Yin X, Ye L, Zhao L, Li L, Song J. Early versus delayed postoperative oral hydration after general anesthesia: a prospective randomized trial. Int J Clin Exp Med. 2014;7(10):3491\u20136.","journal-title":"Int J Clin Exp Med"}],"container-title":["Aesthetic Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-025-04671-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00266-025-04671-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-025-04671-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T13:30:30Z","timestamp":1743773430000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00266-025-04671-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,16]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["4671"],"URL":"https:\/\/doi.org\/10.1007\/s00266-025-04671-9","relation":{},"ISSN":["0364-216X","1432-5241"],"issn-type":[{"type":"print","value":"0364-216X"},{"type":"electronic","value":"1432-5241"}],"subject":[],"published":{"date-parts":[[2025,1,16]]},"assertion":[{"value":"22 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Our authors claim no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The trial was approved by the Ethics Review Committee of West China Hospital of Stomatology (approval number: WCHSIRB-D-2024-002-R2) and registered in the Chinese Clinical Trial Registry () before enrolment (registration number: ChiCTR2400081389, registration time: 29\/02\/2024). Informed consent was obtained from all patients before enrolment.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}