Does inferior alveolar nerve block influence immediate postoperative outcomes in orthognathic surgery? A scoping review

Purpose This scoping review aimed to systematically map and synthesize the available evidence regarding the impact of inferior alveolar nerve (IAN) block on the immediate postoperative outcomes of orthognathic surgery. Methods The review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guideline. A comprehensive and systematic search strategy was implemented across MEDLINE (PubMed), EMBASE, CINAHL, PsycINFO, The Cochrane Library, Livivo, LILACS, Web of Science, Scopus, Epistemonikos, and Google Scholar for grey literature. The search employed the descriptors descriptors “Nerve Block,” “Postoperative Pain,” and “Mandibular Osteotomy,” combined with the Boolean operators AND and OR and their respective synonyms. The findings were synthesized narratively. Results The search yielded 2,235 records, of which 11 studies fulfilled the eligibility criteria. Substantial heterogeneity was identified regarding the type, dosage, formulation of the anesthetic agents, and timing of IAN block administration. Despite such variations, beneficial effects were consistent across the included studies: 63.6% reported a statistically significant reduction in postoperative pain, 62.5% demonstrated reduced opioid consumption, and 66.7% showed a lower incidence of postoperative nausea and vomiting (PONV). The visual analogue scale (VAS) was the most frequently used instrument for postoperative pain assessment. Conclusion The available evidence suggests that the IAN block is associated with reduced postoperative pain, decreased opioid requirements, and a lower incidence of PONV in patients undergoing orthognathic surgery. The heterogeneity observed across anesthetic protocols underscores the need for standardization in future primary studies.