Bilateral greater palatine nerve block for perioperative analgesia in children undergoing palatoplasty

Abstract

Background The aim of this study is to evaluate the efficacy of greater palatine nerve block for perioperative analgesia in children undergoing palatoplasty.Patients and methods This prospective randomized double-blinded study was carried out on 40 patients in Alexandria Main University Hospital scheduled for cleft palate repair. General anaesthesia was induced to all children. Patients were randomly categorized into two equal groups. Group A patients received no block (control group), whereas group B patients received bilateral greater palatine nerve block with 2 ml of 0.25% bupivacaine, 1 ml on each side, before surgical stimulation. Vital signs, time to postanaesthesia awakening, time to first cry and time to feed were recorded. Children and Infants Postoperative Pain Scale (CHIPPS) was used for scoring, and first dose and total dose of analgesic were recorded.Results There were significantly lower postoperative heart rate, mean arterial blood pressure and CHIPPS values in group B than in group A. First dose of diclofenac sodium was given at 1 h postsurgery in group A and at 8 h postsurgery in group B. Total dose of postoperative analgesic requirements was significantly lower in group B (22.73±6.20 mg) than in group A (32.40±3.84 mg) (P≤0.001). The time to postanaesthesia awakening, time to first feed and time to first cry were significantly shorter in group B than in group A (P≤0.001).Conclusion Bilateral greater palatine nerve block provided adequate perioperative analgesia up to 8 h postsurgery, less postoperative analgesic requirements and it shortened the time to postanaesthesia awakening, time to first cry and time to feed.