Abstract No.: ABS1828: A prospective randomised double blinded study to compare the analgesic efficacy of USG guided bilateral suprazygomatic maxillary nerve block(SMB) with 0.25% bupivacaineand 0.25% bupivacaine with dexmedetomidine in children undergoing cleft palate(CP)repair

Abstract

Background & Aims:The aim of this study was to assess the analgesic efficacy of dexmedetomidine as an additive to bupivacaine in childrenundergoing cleft palate (CP) repair with regional nerve block. OFC is one of the most common birth defects in India.Methods:Suprazygomatic maxillary nerve block (SMB) is a simple technique providing effective analgesia with decreased perioperative opioid consumption and complications. • 46 children fulfilling the inclusion criteria planned for CP repair with ultrasound guided (USG) SMB were randomised into Group A and B with comparable demographics and received 0.25% bupivacaine with saline and 0.25% bupivacaine with 1 µg/kg dexmedetomidine respectively. Postoperatively, pain was assessed by Children and Infants Postoperative Pain Scale (CHIPPS) score every 30 minutes for 2 hours and then every 2 hours until 24 hours. The pain control was considered insufficient if CHIPPS score was >3 for which Inj. fentanyl 0.5 µg/kg during first 2 hours and after 2 hours until 24 hours Inj. paracetamol 15 mg/kg were administered respectively and recorded.Results:The CHIPPS score was significantly lower in Group B than Group-A with p-value < 0.05. None of the children in Group-Brequired rescue fentanyl compared to 6 children in Group-A which was statistically significant (p value 0.032). 65.2% children in Group-A required rescue Paracetamol with more frequent administrations compared to only 26% in Group-B which wasstatistically significant (p value 0.048). No significant differences in haemodynamic parameters were noted between the groups intraoperatively.Conclusion:Dexmedetomidine when used as an adjuvant to 0.25% bupivacaine increased the duration of analgesia, reduced postoperative pain and need for rescue analgesics. It also provided stable haemodynamics throughout the intraoperative period with nil complications.