• Paediatric anaesthesia · Feb 2007

    Randomized Controlled Trial Comparative Study

    A comparison of bilateral infraorbital nerve block with intravenous fentanyl for analgesia following cleft lip repair in children.

    • Arvind Rajamani, Vijaylakshmi Kamat, Vardaraja Ponnambalam Rajavel, Jyotsna Murthy, and Syed Altaf Hussain.
    • Department of Anaesthesiology and Critical Care, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Nagar, Chennai, India. rrarvind@yahoo.com
    • Paediatr Anaesth. 2007 Feb 1;17(2):133-9.

    BackgroundThe efficacy of analgesia with bilateral infraorbital nerve block and intravenous (i.v.) fentanyl were compared for cleft lip surgery in children.MethodsEighty-two children aged 3 months to 10 years undergoing cleft lip repair were prospectively randomized to one of two groups: bilateral infraorbital nerve block (Group B), or i.v. fentanyl (Group F). Group B (n = 41) received bilateral infraorbital injection of 1 ml 0.25% bupivacaine and 2 ml i.v. saline as control. Group F (n = 41) received 2 microg x kg(-1) i.v. fentanyl, and bilateral infraorbital injection of 1 ml saline as control. Pain was evaluated by the incidence of tachycardia, hypertension, and/or modified pain score > or =4. The time to awakening, time to first cry and time to feeding were noted.ResultsThirty four children (82.9%) in Group B had adequate analgesia compared with 15 (36.6%) in Group F (P < 0.0001, RR of failure 0.27 for Group B). Group B had a mean time to awakening of 5.65 +/- 2.52 min (Group F: 9.37 +/- 4.50 min; P < 0.0001), time to first cry 32.14 +/- 18.22 min (Group F: 28.00 +/- 16.27 min; P = 0.3), time to feed 62.05 +/- 20.06 min (Group F: 72.44 +/- 17.72; P = 0.015), and pain score 2.81 +/- 1.38 (Group F: 4.71 +/- 1.89; P < 0.0001). There were no major complications.ConclusionsBilateral infraorbital block is superior to fentanyl in terms of analgesia, and time to awakening and feeding.

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