{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T03:02:36Z","timestamp":1779850956898,"version":"3.53.1"},"reference-count":26,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>In this report, we aimed to describe an appropriate setting for a patient-controlled analgesia (PCA) pump for postoperative pain control using local anesthetic after bimaxillary osteotomy, which is considered a highly invasive procedure. We conducted a cadaver study to determine the appropriate flow rate setting and then applied our findings to a clinical case. We examined the distribution of local anesthetic administered as ultrasound-guided inferior alveolar nerve blocks (UGIANBs) at different volumes. Using the same UGIANB approach, we placed an indwelling catheter in a healthy male who had undergone bimaxillary osteotomy and set the PCA pump loaded with 0.2% ropivacaine to continuously administer local anesthetic at a flow rate of 7 mL\/hour with an additional 5-mL bolus per activation and 30-minute lockout. The patient reported no postoperative pain, did not require other analgesics or antiemetics postoperatively, and had no complications. This approach may have a major impact on clinical practice as it enables opioid-free postoperative analgesia, which may accelerate patient recovery by reducing perioperative complications and shortening hospital stays.<\/jats:p>","DOI":"10.2344\/24-0021","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T05:08:16Z","timestamp":1749445696000},"page":"114-118","source":"Crossref","is-referenced-by-count":0,"title":["An Appropriate Setting for a Patient-Controlled Analgesia Pump for Continuous Local Anesthesia After Bimaxillary Osteotomy"],"prefix":"10.2344","volume":"72","author":[{"given":"Yuki","family":"Kojima","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Asahi General Hospital, Chiba, Japan"},{"name":"Department of Dental Anesthesiology, Asahi General Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Tamatsu","sequence":"additional","affiliation":[{"name":"Faculty of Neurology Gross Anatomy Section, Kagoshima University Graduate School Medical and Dental Sciences, Kagoshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i1878-7177-72-2-114-b01","series-title":"Clin Oral Investig","first-page":"2645","article-title":"Intravenous lidocaine for effective pain relief after bimaxillary surgery","volume":"21","author":"Lee U","year":"2017","unstructured":"Lee U,\nChoi YJ,\nChoi GJ,\nKang H. Intravenous lidocaine for effective pain relief after bimaxillary surgery. Clin Oral Investig. 2017;21:2645\u20132652."},{"key":"i1878-7177-72-2-114-b02","series-title":"J Oral Maxillofac Surg","first-page":"818","article-title":"Patient-controlled analgesia and length of hospital stay in orthognathic surgery: a randomized controlled trial","volume":"77","author":"Chang FS","year":"2019","unstructured":"Chang FS,\nBurrows SA,\nGebauer DP. Patient-controlled analgesia and length of hospital stay in orthognathic surgery: a randomized controlled trial. J Oral Maxillofac Surg. 2019;77:818\u2013827."},{"key":"i1878-7177-72-2-114-b03","series-title":"Reg Anesth Pain Med","first-page":"322","article-title":"Bilateral mandibular block improves pain relief and morphine consumption in mandibular osteotomies: a prospective, randomized, double-blind, placebo-controlled clinical trial","volume":"46","author":"Bertuit M","year":"2021","unstructured":"Bertuit M,\nRapido F,\nLy H, et al. Bilateral mandibular block improves pain relief and morphine consumption in mandibular osteotomies: a prospective, randomized, double-blind, placebo-controlled clinical trial. Reg Anesth Pain Med. 2021;46:322\u2013327."},{"key":"i1878-7177-72-2-114-b04","series-title":"JA Clin Rep","first-page":"42","article-title":"Postoperative complications of ultrasound-guided inferior alveolar nerve and maxillary nerve blocks: a retrospective study","volume":"8","author":"Kojima Y","year":"2022","unstructured":"Kojima Y,\nMurouchi T,\nOkayama N,\nAsano K,\nAkiba M,\nHamasaki J. Postoperative complications of ultrasound-guided inferior alveolar nerve and maxillary nerve blocks: a retrospective study. JA Clin Rep. 2022;8:42."},{"key":"i1878-7177-72-2-114-b05","series-title":"Anesth Prog","first-page":"128","article-title":"Perioperative analgesia using an indwelling catheter to deliver an inferior alveolar nerve block: a case report","volume":"70","author":"Kojima Y","year":"2023","unstructured":"Kojima Y,\nAsano K,\nMurouchi T,\nHirabayashi K. Perioperative analgesia using an indwelling catheter to deliver an inferior alveolar nerve block: a case report. Anesth Prog. 2023;70:128\u2013133."},{"key":"i1878-7177-72-2-114-b06","series-title":"Reg Anesth Pain Med","first-page":"625","article-title":"A cadaveric study of ultrasound-guided maxillary nerve block via the pterygopalatine fossa: a novel technique using the lateral pterygoid plate approach","volume":"43","author":"Kampitak W","year":"2018","unstructured":"Kampitak W,\nTansatit T,\nShibata Y. A cadaveric study of ultrasound-guided maxillary nerve block via the pterygopalatine fossa: a novel technique using the lateral pterygoid plate approach. Reg Anesth Pain Med. 2018;43:625\u2013630."},{"issue":"4","key":"i1878-7177-72-2-114-b07","series-title":"Asian J Anesthesiol","first-page":"89","article-title":"Ultrasound-guided maxillary and inferior alveolar nerve blocks for postoperative analgesia in gnathoplasty","volume":"55","author":"Kumita S","year":"2017","unstructured":"Kumita S,\nMurouchi T,\nArakawa J. Ultrasound-guided maxillary and inferior alveolar nerve blocks for postoperative analgesia in gnathoplasty. Asian J Anesthesiol. 2017;55(4):89\u201390. doi: 10.1016\/j.aja.2017.11.001. Epub 2017 Nov 22. PMID: 29198931."},{"key":"i1878-7177-72-2-114-b08","series-title":"Anesth Prog","first-page":"119","article-title":"Preemptive effects of a combination of preoperative diclofenac, butorphanol, and lidocaine on postoperative pain management following orthognathic surgery","volume":"47","author":"Nagatsuka C","year":"2000","unstructured":"Nagatsuka C,\nIchinohe T,\nKaneko Y. Preemptive effects of a combination of preoperative diclofenac, butorphanol, and lidocaine on postoperative pain management following orthognathic surgery. Anesth Prog. 2000;47:119\u2013124."},{"key":"i1878-7177-72-2-114-b09","series-title":"Br J Oral Maxillofac Surg","first-page":"e1","article-title":"Effectiveness of different protocols to reduce postoperative pain following orthognathic surgery: a systematic review and meta-analysis","volume":"60","author":"Alyahya A","year":"2022","unstructured":"Alyahya A,\nAldubayan A,\nSwennen GRJ,\nAl-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:e1\u2013e10."},{"key":"i1878-7177-72-2-114-b10","series-title":"J Anesth","first-page":"46","article-title":"Injectate spread in ultrasound-guided inferior alveolar nerve block: a cadaveric study","volume":"36","author":"Kumita S","year":"2022","unstructured":"Kumita S,\nSawada A,\nTokura TA, et al. Injectate spread in ultrasound-guided inferior alveolar nerve block: a cadaveric study. J Anesth. 2022;36:46\u201351."},{"key":"i1878-7177-72-2-114-b11","series-title":"Anesthesiology","first-page":"645","article-title":"Perioperative opioid administration: a critical review of opioid-free versus opioid-sparing approaches","volume":"134","author":"Shanthanna H","year":"2021","unstructured":"Shanthanna H,\nLadha KS,\nKehlet H,\nJoshi GP. Perioperative opioid administration: a critical review of opioid-free versus opioid-sparing approaches. Anesthesiology. 2021;134:645\u2013659."},{"key":"i1878-7177-72-2-114-b12","series-title":"BMC Anesthesiol","first-page":"34","article-title":"Application of opioid-free general anesthesia for gynecological laparoscopic surgery under ERAS protocol: a non-inferiority randomized controlled trial","volume":"23","author":"Chen L","year":"2023","unstructured":"Chen L,\nHe W,\nLiu X,\nLv F,\nLi Y. Application of opioid-free general anesthesia for gynecological laparoscopic surgery under ERAS protocol: a non-inferiority randomized controlled trial. BMC Anesthesiol. 2023;23:34."},{"key":"i1878-7177-72-2-114-b13","series-title":"Anesthesiology","first-page":"182","article-title":"Infectious risk of continuous peripheral nerve blocks","volume":"110","author":"Capdevila X","year":"2009","unstructured":"Capdevila X,\nBringuier S,\nBorgeat A. Infectious risk of continuous peripheral nerve blocks. Anesthesiology. 2009;110:182\u2013188."},{"key":"i1878-7177-72-2-114-b01","series-title":"Clin Oral Investig","first-page":"2645","article-title":"Intravenous lidocaine for effective pain relief after bimaxillary surgery","volume":"21","author":"Lee U","year":"2017","unstructured":"Lee U,\nChoi YJ,\nChoi GJ,\nKang H. Intravenous lidocaine for effective pain relief after bimaxillary surgery. Clin Oral Investig. 2017;21:2645\u20132652."},{"key":"i1878-7177-72-2-114-b02","series-title":"J Oral Maxillofac Surg","first-page":"818","article-title":"Patient-controlled analgesia and length of hospital stay in orthognathic surgery: a randomized controlled trial","volume":"77","author":"Chang FS","year":"2019","unstructured":"Chang FS,\nBurrows SA,\nGebauer DP. Patient-controlled analgesia and length of hospital stay in orthognathic surgery: a randomized controlled trial. J Oral Maxillofac Surg. 2019;77:818\u2013827."},{"key":"i1878-7177-72-2-114-b03","series-title":"Reg Anesth Pain Med","first-page":"322","article-title":"Bilateral mandibular block improves pain relief and morphine consumption in mandibular osteotomies: a prospective, randomized, double-blind, placebo-controlled clinical trial","volume":"46","author":"Bertuit M","year":"2021","unstructured":"Bertuit M,\nRapido F,\nLy H, et al. Bilateral mandibular block improves pain relief and morphine consumption in mandibular osteotomies: a prospective, randomized, double-blind, placebo-controlled clinical trial. Reg Anesth Pain Med. 2021;46:322\u2013327."},{"key":"i1878-7177-72-2-114-b04","series-title":"JA Clin Rep","first-page":"42","article-title":"Postoperative complications of ultrasound-guided inferior alveolar nerve and maxillary nerve blocks: a retrospective study","volume":"8","author":"Kojima Y","year":"2022","unstructured":"Kojima Y,\nMurouchi T,\nOkayama N,\nAsano K,\nAkiba M,\nHamasaki J. Postoperative complications of ultrasound-guided inferior alveolar nerve and maxillary nerve blocks: a retrospective study. JA Clin Rep. 2022;8:42."},{"key":"i1878-7177-72-2-114-b05","series-title":"Anesth Prog","first-page":"128","article-title":"Perioperative analgesia using an indwelling catheter to deliver an inferior alveolar nerve block: a case report","volume":"70","author":"Kojima Y","year":"2023","unstructured":"Kojima Y,\nAsano K,\nMurouchi T,\nHirabayashi K. Perioperative analgesia using an indwelling catheter to deliver an inferior alveolar nerve block: a case report. Anesth Prog. 2023;70:128\u2013133."},{"key":"i1878-7177-72-2-114-b06","series-title":"Reg Anesth Pain Med","first-page":"625","article-title":"A cadaveric study of ultrasound-guided maxillary nerve block via the pterygopalatine fossa: a novel technique using the lateral pterygoid plate approach","volume":"43","author":"Kampitak W","year":"2018","unstructured":"Kampitak W,\nTansatit T,\nShibata Y. A cadaveric study of ultrasound-guided maxillary nerve block via the pterygopalatine fossa: a novel technique using the lateral pterygoid plate approach. Reg Anesth Pain Med. 2018;43:625\u2013630."},{"issue":"4","key":"i1878-7177-72-2-114-b07","series-title":"Asian J Anesthesiol","first-page":"89","article-title":"Ultrasound-guided maxillary and inferior alveolar nerve blocks for postoperative analgesia in gnathoplasty","volume":"55","author":"Kumita S","year":"2017","unstructured":"Kumita S,\nMurouchi T,\nArakawa J. Ultrasound-guided maxillary and inferior alveolar nerve blocks for postoperative analgesia in gnathoplasty. Asian J Anesthesiol. 2017;55(4):89\u201390. doi: 10.1016\/j.aja.2017.11.001. Epub 2017 Nov 22. PMID: 29198931."},{"key":"i1878-7177-72-2-114-b08","series-title":"Anesth Prog","first-page":"119","article-title":"Preemptive effects of a combination of preoperative diclofenac, butorphanol, and lidocaine on postoperative pain management following orthognathic surgery","volume":"47","author":"Nagatsuka C","year":"2000","unstructured":"Nagatsuka C,\nIchinohe T,\nKaneko Y. Preemptive effects of a combination of preoperative diclofenac, butorphanol, and lidocaine on postoperative pain management following orthognathic surgery. Anesth Prog. 2000;47:119\u2013124."},{"key":"i1878-7177-72-2-114-b09","series-title":"Br J Oral Maxillofac Surg","first-page":"e1","article-title":"Effectiveness of different protocols to reduce postoperative pain following orthognathic surgery: a systematic review and meta-analysis","volume":"60","author":"Alyahya A","year":"2022","unstructured":"Alyahya A,\nAldubayan A,\nSwennen GRJ,\nAl-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:e1\u2013e10."},{"key":"i1878-7177-72-2-114-b10","series-title":"J Anesth","first-page":"46","article-title":"Injectate spread in ultrasound-guided inferior alveolar nerve block: a cadaveric study","volume":"36","author":"Kumita S","year":"2022","unstructured":"Kumita S,\nSawada A,\nTokura TA, et al. Injectate spread in ultrasound-guided inferior alveolar nerve block: a cadaveric study. J Anesth. 2022;36:46\u201351."},{"key":"i1878-7177-72-2-114-b11","series-title":"Anesthesiology","first-page":"645","article-title":"Perioperative opioid administration: a critical review of opioid-free versus opioid-sparing approaches","volume":"134","author":"Shanthanna H","year":"2021","unstructured":"Shanthanna H,\nLadha KS,\nKehlet H,\nJoshi GP. Perioperative opioid administration: a critical review of opioid-free versus opioid-sparing approaches. Anesthesiology. 2021;134:645\u2013659."},{"key":"i1878-7177-72-2-114-b12","series-title":"BMC Anesthesiol","first-page":"34","article-title":"Application of opioid-free general anesthesia for gynecological laparoscopic surgery under ERAS protocol: a non-inferiority randomized controlled trial","volume":"23","author":"Chen L","year":"2023","unstructured":"Chen L,\nHe W,\nLiu X,\nLv F,\nLi Y. Application of opioid-free general anesthesia for gynecological laparoscopic surgery under ERAS protocol: a non-inferiority randomized controlled trial. BMC Anesthesiol. 2023;23:34."},{"key":"i1878-7177-72-2-114-b13","series-title":"Anesthesiology","first-page":"182","article-title":"Infectious risk of continuous peripheral nerve blocks","volume":"110","author":"Capdevila X","year":"2009","unstructured":"Capdevila X,\nBringuier S,\nBorgeat A. Infectious risk of continuous peripheral nerve blocks. Anesthesiology. 2009;110:182\u2013188."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/2\/article-p114.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/2\/article-p114.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/2\/article-p114.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T02:20:05Z","timestamp":1779848405000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/2\/article-p114.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":26,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2344\/24-0021","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}