Addition of dexmedetomidine to bupivacaine for greater palatine nerve block prolongs postoperative analgesia after cleft palate repair.
OBJECTIVE
The effect of dexmedetomidine on the duration of sensory blockade has not been studied in humans. We evaluated the effect of adding dexmedetomidine to bupivacaine on the duration of postoperative analgesia in children who underwent repair of a cleft palate.


METHODS
Thirty children who were scheduled for repair of a complete cleft palate using a combination of general anaesthesia and greater palatine nerve block were allocated randomly into one of two equal groups (n = 15). In both groups, the greater palatine nerve block was performed bilaterally using 0.5 ml of solution on each side. The B group received bupivacaine 0.25%, whereas the BD group received bupivacaine 0.25% with 1 microg kg(-1) dexmedetomidine. Heart rate, systolic blood pressure, pain score, the time to the first request for analgesia, and the degree of sedation were recorded.


RESULTS
There was no difference in haemodynamic variables between the two groups. The pain score was significantly higher in the B group as compared with the BD group. The time to the first request for analgesia was significantly longer in children in the BD group (mean 22 h, range 20.6-23.7 h) as compared with those who received bupivacaine alone (14.2 h, 13-15 h). Sedation scores in the postoperative period did not differ between the study groups.


CONCLUSIONS
Greater palatine nerve block with a combination of dexmedetomidine and bupivacaine increased the duration of analgesia after repair of a cleft palate by 50% with no clinically relevant side effects.
Obayah
Gihan M
GM
Department of Anesthesia, Cairo University, Cairo, Egypt. gobayah@yahoo.com
Refaie
Amira
A
Aboushanab
Ossama
O
Ibraheem
Neamat
N
Abdelazees
Mossad
M
D002045:Bupivacaine / Q000008:administration & dosage*; D002972:Cleft Palate / Q000188:drug therapy / Q000601:surgery*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D021362:Palate, Hard / Q000187:drug effects / Q000294:innervation / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors
D020927:Dexmedetomidine; D002045:Bupivacaine