title: Bilateral suprazygomatic maxillary nerve block for cleft palate repair in children: a prospective, randomized, double-blind study versus placebo.
abstract: BACKGROUND
  The authors investigated the efficacy of bilateral suprazygomatic maxillary nerve block (SMB) for postoperative pain relief in infants undergoing cleft palate repair.
  
  
  METHODS
  In this prospective, double-blind, single-site, randomized, and parallel-arm controlled trial, 60 children were assigned to undergo bilateral SMB with general anesthesia with either 0.15 ml/kg of 0.2% ropivacaine (Ropi group) or 0.15 ml/kg of isotonic saline (Saline group) on each side. The primary endpoint was total postoperative morphine consumption at 48 h. Pain scores and respiratory- and SMB-related complications were noted.
  
  
  RESULTS
  The overall dose of intravenous morphine after 48 h (mean [95% CI]) was lower in the Ropi group compared with that in the Saline group (104.3 [68.9 to 139.6] vs. 205.2 [130.7 to 279.7] μg/kg; P = 0.033). Continuous morphine infusion was less frequent in the Ropi group compared with that in the Saline group (1 patient [3.6%] vs. 9 patients [31%]; P = 0.006). Three patients in the Saline group had an episode of oxygen desaturation requiring oxygen therapy. There were no technical failures or immediate complications of the SMB. Intraoperative hemodynamic parameters, doses of sufentanil, pain scores, and postoperative hydroxyzine requirements were not different between the two groups.
  
  
  CONCLUSIONS
  Bilateral SMB is an easy regional anesthesia technique that reduces total morphine consumption at 48 h after cleft palate repair in children and the use of continuous infusion of morphine and may decrease postoperative respiratory complications.
authors: From the Department of Anesthesiology and Critical Care Medicine, University Montpellier I, and Lapeyronie University Hospital, Montpellier, France.
authors: Julien
authors: J
authors: Chiono
authors: Olivier
authors: O
authors: Raux
authors: Sophie
authors: S
authors: Bringuier
authors: Chrystelle
authors: C
authors: Sola
authors: Michèle
authors: M
authors: Bigorre
authors: Xavier
authors: X
authors: Capdevila
authors: Christophe
authors: C
authors: Dadure
mesh_terms: D000577:Amides / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002675:Child, Preschool; D002972:Cleft Palate / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008442:Maxillary Nerve / Q000187:drug effects* / Q000502:physiology; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077212:Ropivacaine