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Comparative Study of Preoperative Biateral Infraorbital Nerve Block with Peri Inscisional Infiltration for Post Operative Pain Relief in Cleft Lip Surgery

Chandnani S. Anup, A-20 Sunderam Park society, VIP road, Karelibaug, Vadodara – 390018 , Madia Kashmira A.* , Chandnani Anup S.**

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Indian Journal of Anesthesia and Analgesia 4(2):p 409-414, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.8

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Abstract

Background: Post operative pain relief is an integral part of anaesthetic management especially when it comes to pediatric patients where it requires special attention. Aim: to study two different techniques – peri inscisional infiltration with bilateral infra orbital nerve block for post operative pain relief in case of cleft lip repair surgery done in pediatric patients below two years of age for pain relief in post operat period Material and Methods: Sixty patients of either sex were randomly divided in two equal groups with comparable age and weight with duration of surgery lasting around 75 to 90 minutes – one to receive Inj. Bupivacaine 0.25% 1 ml for infraorbital nerve block each side and other for peri inscisional infiltration with Inj Bupivacaine 0.25% 2 ml. After premedication with anticholinergics, general anaesthesia was given with Inj. Ketamine and relaxant Inj. Suxamethonium as per body weight. And bilateral infra orbital nerve block and peri inscisional infiltration was done after intubation. The patients were monitored for vitals, pain relief using Objective Pain Score (Hanallah’s) for pain free period post operatively at the interval of 2, 4, 6, 8, 10, 14, 24 hours. Results: The basic vital. parameters were comparable in both groups and were well within normal range per and post operatively. Hanallah’s paediatric objective pain score [6]at the interval of 2, 4, 6, 8, 10, 14, 24 hours post operatively showed that the average pain relief in infraorbital nerve block group was around 23.12±2.21 hours as compared to 16.33±1.73 hours in the peri inscisional group. The use of rescue analgesia was also earlier in the peri inscisional group. Conclusion: Both techniques are effective in providing good pre emptive and post operative analgesia but bilateral infra orbital nerve block provides a better relief for longer duration avoiding the use of early rescue analgesia.
 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.8

Keywords

Infra Orbital Nerve Block; Peri Inscisional Infiltration; Objective Pain Score.

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