Comparison of Local Anesthetic Effect of Bupivacaine versus Bupivacaine plus Dexamethasone in Nasal Surgery

Document Type: Original



Adequate pain control is an important consideration in the post-surgical management of patients. Local nerve blockade added to general anesthesia can provide excellent pain control during and after most nasal surgical procedures. The aim of this study was to determine the combined effect of local anesthetic drugs with corticosteroids in nasal surgery.
Materials and Methods:
In this double-blind clinical study, 60 patients who underwent different nasal surgical procedures were matched and divided into two equal groups. Bilateral local nerve blockade was used in both groups. Bupivacaine or bupivacaine plus dexamethasone was administered by injection (groups B and B+D, respectively). Postoperative visual analog scale (VAS) pain values and the need for oral/intramuscular analgesic treatment in the first 24 h were recorded in all patients.
Thirty-eight male (63.3%) and 22 female (36.7%) patients were included in this study, with a mean age of 28.3 ± 8.2 years. At 1, 2, 4, 6, and 12 h post surgery, VAS pain values were significantly lower in the B+D group than in the B group. The analgesic requirement was significantly lower in the B+D group compared with the B group. No relevant complications were seen during surgery or postoperative hospitalization.
This study demonstrates the positive effect of a combination of a dexamethasone with a bupivacaine in reducing pain and the need for analgesic drugs after different nasal surgeries. No acute or short-term post-surgical complications were observed in this study. 


1. Flint PW. Cummings Otolaryngology Head and Neck Surgery. 5th ed. Philadelphia: Mosby; 2010:112.

2. Flint PW. Cummings Otolaryngology Head and Neck Surgery. 5th ed. Philadelphia: Mosby; 2010: 501–2.

3. Miller RD. Millers Anesthesia. 7th ed. Philadelphia: Churchill Living Stone; 2010: 2366–67.

4. Miller RD. Millers Anesthesia. 7th ed. Philadelphia: Churchill Living Stone; 2010: 927.

5. Nahler G. Dictionary of Pharmaceutical Medicine. 2nd ed. Vienna: Springer; 2009: 189.

6. Mariano ER, Watson D, Loland VJ, Chu LF, Cheng GS, Mehta SH, et al. Bilateral infraorbital nerve blocks decrease postoperative pain following nasal surgery. Can J Anesth 2009; 56(8): 584–9.                                            

7. Leong P, Darvasula VSP, Boardman S, Back G. Bupivacaine in nasal packs as topical analgesia after nasal surgery. International Congress Series 2003; 1240: 523–9. 

8. Mariano ER, Chu LF, Loland VJ, Cheng GS, Ilfeld BM. Effect of infraorbital blocks on recovery duration following nasal surgery. Anesthesiology 2008; 109:A1089.

9. Buchanan MA, Dunn GR, MacDougall GM. Effect of topical bupivacaine on post-operative pain in bilateral nasal surgery. J Larygol Otol 2005; 119(4): 284–8.       

10. Demiraran Y,Ozturk O, Guclu E, Iskender A,  Ergin MH, Tokmak A. Analgesic efficacy of locally infiltrated Levobupivacaine for nasal surgery. Anesth Analg 2008; 106(3): 1008–11.

11. Yilmaz YF, Ozlage dik S, Titiz A, Tuncay A, Ozcan M, Unal A. Comparison of Levo-bupivacaine and lidocaine for postoperative analgesia  following septoplasty. Rhinol Journals 2008; 46(4): 289–91. 

12. Kopacz DJ, Lacouture PG, Wu D, Nandy P, Swanton R, Landau C. The dose response and effects of dexamethasone on bupivacaine for intercostal blockade in healthy volunteers. Anesth Analg 2005; 96(2): 576–82.

13. Movafegh A, Razazian M, Hajimohamadi F, Meysamie A. Dexamethasone added to lidocaine prolongs axillarybrachial plexus blockade. Anesth Analg 2006; 102(1): 263–7.