Cleft Palate Repair: A New Maxillary Nerve Block Approach

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pain Management

Background:

• Cleft palate repair often involves significant postoperative pain.
• Traditional pain management may rely on opioids, leading to respiratory complications.
• Effective pain control is crucial for patient recovery and reducing hospital stay.

Purpose of the Study:

• To evaluate a modified approach for maxillary nerve block (MNB) in primary cleft palate repair.
• To assess the efficacy of MNB in reducing opioid requirements and postoperative complications.
• To provide adequate intraoperative and postoperative pain relief.

Main Methods:

• A prospective clinical trial involving 60 pediatric patients undergoing primary cleft palate repair.
• Comparison between two groups: Hospital A (bilateral regional MNB with general and local anesthesia) and Hospital B (traditional general anesthesia with local anesthesia).
• Monitoring of hemodynamic parameters, pain signals, respiratory depression, feeding, and discharge times.

Main Results:

• No significant differences in pain indicators during surgery between groups.
• Significant improvements in postoperative recovery parameters favoring the MNB group (Hospital A).
• The MNB group demonstrated better outcomes in terms of patient reactivity and reduced airway depression symptoms.

Conclusions:

• Bilateral regional MNB via the sphenopalatine foramina is an effective, safe, and easy method for pain management in cleft palate repair.
• Combining regional blocks with light general and local anesthesia is a viable strategy to minimize opioid use.
• This approach helps prevent neurotoxicity, respiratory depression, nausea, and vomiting, promoting early feeding and discharge.