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Infra-orbital Nerve Block for Post Operative Analgesia in Children Undergoing Cleft Lip Surgery.

Phase 2
Completed
Conditions
Postoperative Pain
Interventions
Registration Number
NCT02514980
Lead Sponsor
Assiut University
Brief Summary

this study will be undertaken to evaluate the safety and analgesic efficacy of adding ketamine to bupivacaine in bilateral infra-orbital nerve block for relief of pain postoperatively following repair of cleft lip in children less than two years of age.

Detailed Description

Oro-facial clefts are the most prevalent craniofacial birth defects and the second most common birth anomaly, second only to clubfoot \[Strong \& Buckmiller 2001\]. Cleft lip surgery is associated with appreciable postoperative pain in children Alleviation of postoperative pain is important in these patients. The fear of respiratory depression using opioids has renewed the interest in regional anesthesia to provide safe and effective postoperative analgesia. Infra-orbital nerve block has been advocated as a suitable local analgesic technique for cleft lip surgery and superficial surgery on the mid face \[Morton 2004, Takmaz et al. 2009, Rajesh et al. 2011, Jindal et al. 2011\].The infra-orbital nerve supplies the upper lip, lower eyelid, and adjacent skin of the cheek and nose. Unilateral or bilateral infra-orbital nerve block has been performed with a very high success rate.

The investigators designed this study to evaluate the safety and analgesic efficacy of adding ketamine to bupivacaine in bilateral infra-orbital nerve block for relief of pain postoperatively following repair of cleft lip in children less than two years of age.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria

(ASA) physical status I and II aged less than 2 years undergoing elective cleft lip repair (with or without cleft palate) under general anesthesia.

Exclusion Criteria

Patients with local infection at the site of injection of block, history suggestive of drug allergy, any systemic disease that compromises the cardiovascular, respiratory or neurological function, other congenital anomaly, history of upper or lower airway disease, coagulation disorders, and children with history of sleep apnea and in whom postoperative ventilation may be required will be excluded from the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bupivacaine groupBupivacaineInfraorbital nerve block using bupivacaine 0.25% on each side.
Bupivacaine-Ketamine group.BupivacaineInfraorbital nerve block using bupivacaine 0.25% combined with 0.5mg/kg ketamine on each side.
Bupivacaine-Ketamine group.KetamineInfraorbital nerve block using bupivacaine 0.25% combined with 0.5mg/kg ketamine on each side.
Primary Outcome Measures
NameTimeMethod
postoperative analgesic consumption24 hours postoperative

the total consumption of analgesics in the first 24h postoperative

Secondary Outcome Measures
NameTimeMethod
Postoperative The Face, Legs, Activity, Cry, Consolability ( FLACC) pain score24 h postoperative.

FLACC pain score will be recorded on arrival to the recovery room (0) and at 1, 2, 3, 4, 8, 12, and 24 hours postoperative.

Parent satisfaction score24 h postoperative

The parents will be asked to evaluate their satisfaction regarding pain control at the end of 24 hours over a score of 4 points (1=bad, 2=moderate, 3=good, 4=excellent).

Trial Locations

Locations (1)

Assiut university hospitals

🇪🇬

Assiut, Assiut governorate, Egypt

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