Bilateral infraorbital block with 0.5% bupivacaine as post-operative analgesia following cheiloplasty in children.

Abstract

Various studies have shown that bupivacaine nerve blocks provide prolonged post-operative analgesia. We studied the efficacy of a 0.5% bupivacaine infraorbital nerve block as post-operative analgesia in a random, prospective, double blind manner in children undergoing cleft lip repair. Following the induction of anesthesia with ketamine 2-4 mg/kg im, 60 patients, aged 2-13 years, ASA I and II were equally divided: Group A received 1-1.5 ml bupivacaine, 0.5% with 1:200,000 epinephrine; Group B received 1-1.5 ml saline injected into the vicinity of the infraorbital foramina. In every patient, the surgeon infiltrated the lip with 4-7 ml of 1% lidocaine with 1:100,000 epinephrine for both anesthesia and hemostasis. Post-operative evaluations were completed after 4, 8, and 12 to 24 hours and were based on a visual analogue scale for pain. Similarly, the nurses and the parents also evaluated post-operative discomfort using specific criteria. All the observers were kept unaware of the solutions used for the block. The results showed that Group A was pain free for a mean duration of 19.4 +/- 5.06 (SD) hours in contrast to 11.7 +/- 6.19 hours for Group B, (p less than 0.001). Group A required no other analgesic whereas a total of 17 patients in Group B required analgesic medication starting at four hours post-operatively, (p less than 0.001). Both the nurses and the parents confirmed that those who received infraorbital block were more comfortable than those who did not. One-way analysis of variance indicates that the mean scores for both groups differs significantly at all levels of comparison, (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: H F Nicodemus, M J Ferrer, V C Cristobal, L de Castro
• Journal: Scandinavian journal of plastic and reconstructive surgery and hand surgery (Scand J Plast Reconstr Surg Hand Surg) Vol. 25 Issue 3 Pg. 253-7 ( 1991) ISSN: 0284-4311 [Print] England
• PMID: 1780723 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Bupivacaine

Topics

• Bupivacaine
• Child
• Child, Preschool
• Cleft Lip (surgery)
• Female
• Humans
• Male
• Maxillary Nerve
• Nerve Block
• Pain Measurement
• Pain, Postoperative (prevention & control)