Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparison between the Effect of Bupivacaine-Pethidine and Bupivacaine-Ketamine as Preemptive in Bilateral Infraorbital Nerve Block on Postoperative Pain Relief in Infants Undergoing Clef Lip Repair, a Controlled Study

Document Type : Original Article (s)

Authors
Hamid Hajigholam Saryazdi 1
Amir Shafa 2
Farzaneh Nakhodaei 3
1 Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: The aim of this study was to compare the effect of pethidine and ketamine, when added to bupivacaine, in infraorbital nerve block on postoperative pain relief in cleft lip repair surgery in infants.Methods: In this double-blind clinical trial study, sixty candidates of cleft lip repair surgery were randomly allocated in three groups: bupivacaine + ketamine (a), bupivacaine + pethidine (b), and bupivacaine (c). Hemodynamic parameters and pain score were measured and compared among the three groups.Findings: Mean pain score, heart rate, and mean arterial blood pressure were significantly higher in group c than the two other groups (P < 0.05); but, there was no significant difference between groups a and b (P > 0.05).Conclusion: Based on the results of the present study, using ketamine or pethidine can reduce severity of pain in infraorbital nerve block with no complication. There was no difference between ketamine and pethidine, when added to bupivacaine, on postoperative pain relief.
Keywords
Cleft lip
Pediatric anesthesia
Nerve block
  1. Rajamani A, Kamat V, Rajavel VP, Murthy J, Hussain SA. A comparison of bilateral infraorbital nerve block with intravenous fentanyl for analgesia following cleft lip repair in children. Paediatr Anaesth 2007; 17(2): 133-9.
  2. Eipe N, Choudhrie A, Pillai AD, Choudhrie R. Regional anesthesia for cleft lip repair: a preliminary study. Cleft Palate Craniofac J 2006; 43(2): 138-41.
  3. Simion C, Corcoran J, Iyer A, Suresh S. Postoperative pain control for primary cleft lip repair in infants: is there an advantage in performing peripheral nerve blocks? Paediatr Anaesth 2008; 18(11): 1060-5.
  4. Mariano ER, Watson D, Loland VJ, Chu LF, Cheng GS, Mehta SH, et al. Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery. Can J Anaesth 2009; 56(8): 584-9.
  5. Cekic B, Geze S, Erturk E, Akdogan A, Eroglu A. A comparison of levobupivacaine and levobupivacaine-tramadol combination in bilateral infraorbital nerve block for postoperative analgesia after nasal surgery. Ann Plast Surg 2013; 70(2): 131-4.
  6. Jonnavithula N, Durga P, Kulkarni DK, Ramachandran G. Bilateral intra-oral, infra-orbital nerve block for postoperative analgesia following cleft lip repair in paediatric patients: comparison of bupivacaine vs bupivacaine-pethidine combination. Anaesthesia 2007; 62(6): 581-5.
  7. Jindal P, Khurana G, Dvivedi S, Sharma JP. Intra and postoperative outcome of adding clonidine to bupivacaine in infraorbital nerve block for young children undergoing cleft lip surgery. Saudi J Anaesth 2011; 5(3): 289-94.
  8. Mane RS, Sanikop CS, Dhulkhed VK, Gupta T. Comparison of bupivacaine alone and in combination with fentanyl or pethidine for bilateral infraorbital nerve block for postoperative analgesia in paediatric patients for cleft lip repair: A prospective randomized double blind study. J Anaesthesiol Clin Pharmacol 2011; 27(1): 23-6.
  9. Clerc S, Vuilleumier H, Frascarolo P, Spahn DR, Gardaz JP. Is the effect of inguinal field block with 0.5% bupivacaine on postoperative pain after hernia repair enhanced by addition of ketorolac or S(+) ketamine? Clin J Pain 2005; 21(1): 101-5.
  10. Feriani G, Hatanaka E, Torloni MR, da Silva EM. Infraorbital nerve block for postoperative pain following cleft lip repair in children. Cochrane Database Syst Rev 2016; 4: CD011131.
  11. Moradi-Farsani D, Akrami F, Naghibi K, Alikiaii B, Nazemorroaya B. The effect of age and sex on postoperative pain after deep vitrectomy. J Isfahan Med Sch 2017; 34(415): 1660-5. [In Persian].
  12. Moradi-Farsani D, Naghibi K, Taheri S, Ali-Kiaii B, Rahimi-Varposhti M. Effects of age and gender on acute postoperative pain after cataract surgery under topical anesthesia and sedation. J Isfahan Med Sch 2017; 34(414): 1627-33. [In Persian].
  13. Rahimi M, Farsani DM, Naghibi K, Alikiaii B. Preemptive morphine suppository for postoperative pain relief after laparoscopic cholecystectomy. Adv Biomed Res 2016; 5: 57.
Journal of Isfahan Medical School
Volume 35, Issue 433 - Serial Number 433
May and June 2017
Pages 648-654

  • Receive Date 18 February 2017
  • Accept Date 06 April 2022