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Ultrasound-guided suprazygomatic maxillary nerve block (SMNB) will be performed in paediatric patients with or without the aid of ultrasound guidance. Magnetic resonance imaging (MRI) is used to visualize the spread of the local anaesthetic (LA) spread after suprazygomatic injection and to verify LA contact with the maxillary nerve in the pterygopalatine fossa (PPF).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ultrasound guided Suprazygomatic Maxillary Nerve Block | Active Comparator | An ultasound guided SMNB is admitted on one half of the patients face (left or right) according to randomiced allocation. 0.15 ml/kg of bupivacaine 0.25 mg/ml with epinephrin 5 mcg/ml is injected. |
|
| Landmark guided Suprazygomatic Maxillary Nerve Block landmark | Active Comparator | A langmark guided SMNB is admitted on the other half of the patients face (left or right) according to randomiced allocation. 0.15 ml/kg of bupivacaine 0.25 mg/ml with epinephrin 5 mcg/ml is injected. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nerve block | Other | Suprazygomatic maxillary nerve block |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rate of LA spread into the PPF | Local anesthetic spread to the maxillaris nerve in the pterygopalatine fossa detected by MRI (binary outcome) | day one - within an hour after intervention (peripheral nerve block) |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of LA spread to other anatomical areas and structures | Local anaesthetic spread to orbita, nasal cavity, cranial fossa, infratemporal fossa, or other structures detected by MRI (binary outcome) | day one - within an hour after intervention (peripheral nerve block) |
| Rate of hematoma |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Axel Sauter, MD PhD | Contact | 93484022 | +47 | axsa@online.no |
| Nergis Suleiman, MD | Contact | 23070000 | +47 | nergis.nina.suleiman@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Axel Sauter, MD PhD | Oslo University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oslo University Hospital | Recruiting | Oslo | 0488 | Norway |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40216530 | Derived | Suleiman NN, Lien I, Akhavi MS, Impieri D, Ullensvang K, Moen JM, Lindholm P, Langesaeter E, Sauter AR. Ultrasound guidance does not improve local anesthetic distribution in suprazygomatic maxillary nerve blocks in pediatric patients: a clinical, randomized, controlled, observer-blinded, crossover MRI trial. Reg Anesth Pain Med. 2026 Jun 5;51(6):700-706. doi: 10.1136/rapm-2025-106439. |
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| ID | Term |
|---|---|
| D002972 | Cleft Palate |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D007569 | Jaw Abnormalities |
| D007571 | Jaw Diseases |
| D009140 | Musculoskeletal Diseases |
| D019767 | Maxillofacial Abnormalities |
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| ID | Term |
|---|---|
| D009407 | Nerve Block |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
| D003714 | Denervation |
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Accumulation of blood detected by MRI (binary outcome) |
| day one - within an hour after intervention (peripheral nerve block) |
| Superior-inferior needle angle | Angle of the injection needle meassured in a coronal plane | day one - immediately after intervention (peripheral nerve block) |
| Anterior-posterior needle angle | Angle of the injection needle meassured in a sagittal plane | day one - immediately after intervention (peripheral nerve block) |
| Needle depth | Depth of the injection needle | day one - immediately after intervention (peripheral nerve block) |
| Side effects and adverse events | All side effects or adverse events that might be detected | day one |
| Postoperative analgesic consumption | Opioid consumption during the first 24 hours after surgery | day one and day two |
| MRI time | Time consumption for MRI | day one |
| D019465 |
| Craniofacial Abnormalities |
| D009139 | Musculoskeletal Abnormalities |
| D009057 | Stomatognathic Diseases |
| D009056 | Mouth Abnormalities |
| D009059 | Mouth Diseases |
| D018640 | Stomatognathic System Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019635 |
| Neurosurgical Procedures |
| D013514 | Surgical Procedures, Operative |