Trial reportJournal of pain research2026
Effects of Infraorbital Nerve Block with Dexmedetomidine-Added Bupivacaine on Intraoperative Opioid Consumption and Postoperative Analgesia During Endoscopic Transsphenoidal Surgery: A Prospective, Randomized, Double-Blind Controlled Trial.
Trial report in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04785222 (The Effects of Infraorbital Nerve Block With Dexmedetomidine Added to Bupivacaine on Fentanyl Requirement During Endoscopic Transsphenoidal Approach to Remove Pituitary Tumor), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effects of Infraorbital Nerve Block With Dexmedetomidine Added to Bupivacaine on Fentanyl Requirement During Endoscopic Transsphenoidal Approach to Remove Pituitary Tumor: Prospective Randomized Double Blinded Control Study
Who cites it
1 citing paper in PubMed.
- A Critical Methodological Concern: Per-Protocol Analysis Undermines Randomization in Endoscopic Transsphenoidal Surgery Analgesia Trial [Letter].Journal of pain research · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: In endoscopic transsphenoidal surgery (ETSS) for pituitary adenoma, perioperative discomfort often requires opioid use under general anesthesia. Infraorbital nerve block (IONB), which targets nasal structures involved in ETSS-related pain, may improve analgesia. Combining dexmedetomidine with bupivacaine for IONB may further reduce intraoperative opioid requirements and improve recovery. Patients and Methods: In this prospective, randomized, double-blind study, total of 63 patients was randomized and undergoing ETSS received bilateral ultrasound-guided IONB and were assigned to dexmedetomidine + bupivacaine (2 mL of 0.5% bupivacaine with 5 µg dexmedetomidine per side), bupivacaine alone (2 mL of 0.5% per side), or control (2 mL of normal saline per side). 47 patients were included in the final analysis. The study aimed to evaluate the effects of IONB with dexmedetomidine-added bupivacaine on intra/postoperative analgesic requirements and postoperative pain scores. The study was registered on ClinicalTrials.gov (ID: NCT04785222) on 3 March 2021. Results: The dexmedetomidine + bupivacaine group required significantly less intraoperative fentanyl (1.80 ± 0.67 mcg/kg) than the bupivacaine (2.26 ± 0.78 mcg/kg) and control (2.83 ± 1.87 mcg/kg) groups (p < 0.001). Adjusted analysis showed a mean difference reduction of 1.12 mcg/kg in fentanyl use in the dexmedetomidine added group (p = 0.037). Regarding postoperative analgesic requirements, the time to first rescue fentanyl dose was significantly longer in the dexmedetomidine-added group (+33.9 minutes; p < 0.001), while the requirements for other postoperative analgesics were lower. Postoperative pain scores from the immediate postoperative up to 48 hours, and adverse events showed no significant differences. Hemodynamic parameters, hypotension and bradycardia, were comparable among groups. Conclusion: IONB with dexmedetomidine-added bupivacaine reduces intraoperative fentanyl use and prolong time for rescue opioid requirements during ETSS without increasing hemodynamic risk. Although postoperative pain scores were comparable among all groups, the intraoperative opioid-sparing effect support its role in multimodal analgesia for neurosurgical anesthesia.
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