The study will evaluate the efficacy of bilateral infraorbital nerve block versus preoperative nasal packing with long-acting local anesthetic bupivacaine in term of maintaining hemodynamics intraoperative within 20% below baseline to achieve adequate hypotensive anesthesia and longer duration of postoperative analgesia up to 24 hours in patients undergoing transsphenoidal pituitary adenoma resection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
the patients will receive bilateral infraorbital block
the patients will receive topical intranasal application of bupivacaine
Kasr Alaini hospital
Cairo, Egypt
Mean arterial blood pressure
Time frame: at the time of mucosal dissection
Intraoperative need for magnesium sulphate
Intraoperative need for iv magnesium sulphate up to 3 mg to maintain blood pressure 20% below baseline
Time frame: the entire duration of surgery
Intraoperative need for fentanyl
Intraoperative need for iv fentanyl blouses 0.5 μg/kg (maximum total dose 5 μg/kg for the entire procedure) if no response to magnesium sulphate
Time frame: the entire duration of surgery
Intraoperative need for nitroglycerine
Intraoperative need for iv nitroglycerine infusion (5 - 100 mic/min iv) if no response to magnesium sulphate and fentanyl
Time frame: the entire duration of surgery
Postoperative need of pethidine
Postoperative need of pethidine boluses 25 mg with max.100 mg
Time frame: 24 hours postoprative
Postoperative pain assessed by Numeric pain score
Pain score will be assessed postoperatively (using the verbal Numeric Rating Scale \[NRS\] 0-100; 0 = Non ,100 = Worst imaginable pain)
Time frame: 24 hours postoprative
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