title: A comparison of bilateral infraorbital nerve block with intravenous fentanyl for analgesia following cleft lip repair in children.
abstract: BACKGROUND
  The efficacy of analgesia with bilateral infraorbital nerve block and intravenous (i.v.) fentanyl were compared for cleft lip surgery in children.
  
  
  METHODS
  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 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Bilateral infraorbital block is superior to fentanyl in terms of analgesia, and time to awakening and feeding.
authors.affiliation: Department of Anaesthesiology and Critical Care, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Nagar, Chennai, India. rrarvind@yahoo.com
authors.forename: Arvind
authors.initials: A
authors.lastname: Rajamani
authors.forename: Vijaylakshmi
authors.initials: V
authors.lastname: Kamat
authors.forename: Vardaraja Ponnambalam
authors.initials: VP
authors.lastname: Rajavel
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Murthy
authors.forename: Syed Altaf
authors.initials: SA
authors.lastname: Hussain
mesh_terms: D000698:Analgesia / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D012965:Sodium Chloride; D005283:Fentanyl; D002045:Bupivacaine