Postoperative analgesia effect of levobupivacaine combined with dexmedetomidine in infraorbital nerve block for cleft lip repair in children

Abstract

Objective To investigate the postoperative analgesic effect of levobupivacaine combined with dexmedetomidine applied to infraorbital nerve block for cleft lip repair in children. Methods A total of 60 children who were diagnosed as congenital cleft lip and underwent cleft lip repair surgery in Guangzhou Women and Children′s Medical Center from April to July 2016 were selected as study objects. According to the random number table, the 60 patients were divided into 3 groups, LD group (received levobupivacaine and dexmedetomidine for infraorbital nerve block), L group (received levobupivacaine for infraorbital nerve block), and control group (received normal saline solution for infraorbital nerve block), 20 cases for each group. FLACC scale values were used to evaluate the postoperative pain. The FLACC scores at 0.5, 1, 2, 4, 8, 12 h after cleft lip repair, the analgesics drug requirements and adverse reactions were compared among 3 groups statistically. This study has been approved by the ethics committee of Guangzhou Women and Children′s Medical Center and all the parents of participants signed the informed consents. Results ①There were no significant differences among 3 groups of congenital cleft lip children in age, gender constituent ratio, body weight and durations of surgery (P>0.05). ②The FLACC scores of 0.5 and 1 h after operation in LD group were lower than those of L group and control group, respectively, the FLACC scores of 0.5 and 1 h after operation in L group were lower than those of control group, and all the differences above were statistically significant (P 0.05). ③ Effective analgesia time in LD and L group were longer than that of control group, respectively, effective analgesia time in LD group was longer than that of L group, and all the differences were statistically significant (P<0.05). Acetaminophen use rates and total dose of sufentanil in LD and L group were lower or less than those of control group, respectively, acetaminophen use rates and total dose of sufentanil in LD group were lower or less than those of L group, and all the differences were statistically significant (P<0.05). ④ There were no significant differences among 3 groups in adverse reaction rate (χ2=3.25, P=0.420). Conclusion Levobupivacaine combined with dexmedetomidine for infraorbital nerve block analgesia is safe and effective for children after cleft lip repair. Key words: Levobupivacaine; Dexmedetomidine; Nerve block; Cleft lip; Analgesia; Child