Nerve Blocks

This study will examine nerve problems after combat-related injuries to the arms or legs. Some patients receive a peripheral nerve block, an injection of local anaesthetic near a nerve, to help control pain. However, combat injuries themselves can damage nerves through blast effects, fractures, blood vessel injury, bleeding, infection, surgery, or use of a tourniquet. The study will follow adults with combat-related limb injuries who receive routine care at a specialised trauma centre. Treatment will not be assigned by the study. Researchers will record details of the injury, pain treatment, nerve block use, and nerve function over time. The main goal is to determine how often patients have new or worsened numbness, weakness, or nerve pain after injury, and whether these problems are more closely related to the injury itself, the nerve block, or several factors together. The findings may help clinicians provide safer pain treatment and recognise nerve problems earlier.

Septorhinoplasty is generally a prolonged surgical procedure that frequently involves osteotomy, which may lead to increased intraoperative remifentanil requirements. Moreover, it is often associated with significant bleeding due to the dense capillary network of the nasal region, making the maintenance of low-to-normal blood pressure preferable during surgery. Consequently, achieving stable hemodynamics and providing sufficient analgesia throughout the procedure is essential. This study aims to evaluate the effects of bilateral maxillary nerve block on intraoperative remifentanil consumption and postoperative analgesic efficacy in patients undergoing Septorhinoplasty. A total of 90 patients will be included in the study. Forty-five patients (Group M) will undergo Septorhinoplasty under general anesthesia combined with bilateral maxillary nerve block, while the remaining 45 patients (Group N) will receive general anesthesia alone. In the preoperative phase, a bilateral maxillary nerve block will be performed under ultrasound guidance via the pterygopalatine fossa. During the intraoperative period, total remifentanil consumption will be recorded, alongside assessments of hemodynamic stability, sevoflurane consumption, extubation time, intraoperative bleeding volume, and the satisfaction levels of both the anesthesiologist and the surgeon. In the postoperative period, patient satisfaction, pain scores at 0, 1, 2, 4, 6, 12, 18, and 24 hours as well as at 1 month (measured using the Visual Analog Scale - VAS), additional analgesic requirements, and Quality of Recovery-15 (QoR-15) scores (assessed on preoperative day 1, postoperative day 1, and at 1 month) will be evaluated.