Combined use of infraorbital and external nasal nerve blocks for effective perioperative pain control during and after cleft lip repair.
Perioperative analgesia in patients undergoing cleft lip and palate repair is complicated by the risk of postoperative airway obstruction. We describe a technique of combined infraorbital and external nasal nerve blocks to reduce the need for opioid analgesia. Using this technique, we have successfully performed cleft lip repair under local anesthesia alone, without general anesthesia or intravenous sedation, in adolescents and adults. In children, this technique can reduce the need for postoperative opioids. We describe this novel analgesic approach to decrease opioid requirements and minimize perioperative risk.
Department od Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, MA, USA.
Mariah L
ML
Salloum
Kyle R
KR
Eberlin
Navil
N
Sethna
Usama S
US
Hamdan
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D002971:Cleft Lip / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000627:therapeutic use; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009407:Nerve Block / Q000379:methods*; D009666:Nose / Q000294:innervation*; D009915:Orbit / Q000294:innervation*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011318:Prilocaine / Q000627:therapeutic use; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine