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

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The efficacy of analgesia with bilateral infraorbital nerve block and intravenous (i.v.) fentanyl were compared for cleft lip surgery in children.


Eighty-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 μg·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 ≥4. The time to awakening, time to first cry and time to feeding were noted.


Thirty 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.


Bilateral infraorbital block is superior to fentanyl in terms of analgesia, and time to awakening and feeding.

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