Int J Stomatol

Int J Stomatol ›› 2022, Vol. 49 ›› Issue (6): 657-662.doi: 10.7518/gjkq.2022088

• Original Articles • Previous Articles     Next Articles

Analgesic effects of local anesthesia after cleft lip and palate repair

Pei Ling1(),Zeng Ni1(),Yang Chao1,Wang Yan1,He Miao1,Luo Qiang2,Shi Bing1   

  1. 1.State Key Laboratory of Oral Diseases ＆ National Clinical Research Center for Oral Diseases ＆ Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.State Key Laboratory of Oral Diseases ＆ National Clinical Research Center for Oral Disea-ses ＆ Dept. of Anesthesiology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-03-07 Revised:2022-06-22 Online:2022-11-01 Published:2022-11-03
  • Contact: Ni Zeng E-mail:2770310864@qq.com;zengnihx@sina.com

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Abstract:

Objective This study aimed to compare the effect of different local anesthesia during general anesthesia on postoperative pain relief after cleft lip and palate (CLP) surgery. Methods A total of 92 CLP children at the age ran-ging from 2 months to 6 years, who were admitted to the hospital from June 2021 to January 2022, were selected as objects. All patients were divided into three groups as follows: control group, local injection of normal saline preoperative; infiltration group: local infiltration anesthesia preoperative; and block group, bilateral suprazygomatic maxillary nerve block preoperative. All patients received sufentanil for general analgesia and acetaminophen 2 h postoperative. The admi-nistration of sevoflurane and sufentanil during general anesthesia was recorded. Hemodynamic changes in patients 10 min before surgery, 5 min before surgery, at the beginning of surgery, and 30 min after the beginning of surgery were collec-ted. FLACC scores were also recorded from the time of transferring to the post-anesthesia care unit (PACU) to 24 h after surgery. The number of children with mode-rate and severe pain at each observation time was recor-ded. Results No significant difference was found in the dosage of sevoflurane and sufentanil [(0.34±0.09) μg·kg-1] among all groups. No significant difference was also found in blood pressure and heart rate at continuous time points among all groups. A statistical difference in FLACC score was observed between the control group and the infiltration group at 3 h after transferring to PACU. A statistical difference was also found in the number of patients with moderate and severe pain between the block group and the infiltration group at 4 h after transferring to PACU. The FLACC score and the number of patients with moderate and severe pain increased in the infiltration group and the block group 8-16 h after transferring to PACU, whereas the control group showed a continuous downtrend during this period. Conclusion Under the condition of conventional dose of sufentanil [(0.34±0.09) μg·kg-1] combined with oral analgesics, local anesthetics showed no obvious advantage in postoperative analgesia.

Key words: cleft lip and palate repair, postoperative analgesia, local anesthesia, maxillary nerve block, rebound pain

CLC Number: 

  • R 782.2

TrendMD: 

Tab 1

Basic information of all groups x±SD"

项目对照组浸润组阻滞组P值
麻醉分级（Ⅱ）3130311.000
性别（男/女）18/1320/1021/100.685
年龄/月15.5±16.712.2±13.216.6±18.40.642
手术方式（唇/腭）15/1614/1615/160.988
舒芬太尼/（μg·kg-1）0.36±0.770.34±0.120.32±0.730.295
七氟烷/（mL·kg-1）4.40±2.054.18±1.484.65±1.790.590

Fig 1

Comparison of blood pressure and heart rate change among all groups"

Tab 2

Comparison of FLACC scores and the number of patients with moderate to severe pain among all groups x±SD"

测量项目0 h0.5 h1 h1.5 h2 h2.5 h3 h3.5 h4 h8 h12 h16 h20 h24 h

FLACC

评分

对照组5.2±2.43.5±3.22.5±2.13.2±2.42.6±2.32.1±1.51.7±1.41.2±1.41.2±1.30.8±1.51.0±1.40.4±0.70.2±0.40.1±0.3
浸润组5.5±2.53.9±3.93.3±3.42.9±3.42.7±2.71.9±1.90.8±1.00.9±1.20.9±1.11.4±1.51.4±1.90.9±1.50.3±0.80.1±0.3
阻滞组5.4±2.73.5±2.13.2±2.22.5±1.91.6±1.71.4±1.61.2±1.61.2±1.61.4±1.90.8±1.31.1±1.90.9±1.40.3±0.70.1±0.3
P值0.6070.7770.5690.4670.2720.2130.021*0.6010.5950.0820.4620.2120.8660.998
中重度疼痛人数对照组281613149432222000
浸润组251511119800034210
阻滞组23151294434624400
P值0.2480.9690.9140.4250.2130.2680.2150.1280.025*0.8360.6270.1230.3561

Fig 2

Comparison of FLACC scores (left) and the number of patients with moderate to severe pain (right) among all groups"

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