ABSTRACT
Good pain relief after palatoplasty is important as inadequate analgesia with vigorous cry leads to wound dehiscence, removal of sutures and extra nursing care. Decrease in oxygen requirement and cardio-respiratory demand occur with good pain relief and also promotes early recovery. Preoperative opioids have concerns like sedation, respiratory depression and airway compromise. Greater palatine nerve block with bupivacaine is safe and effective without the risk of respiratory depression. The study was done to compare pain relief postoperatively with intravenous fentanyl and greater palatine nerve block in children following palatoplasty. Methods80 children of ASA I & II, between 1 to 7 years were included and allocated into two groups of 40 each. Analgesic medication was given preoperatively after induction of general anaesthesia, children in Group B received greater palatine nerve block with 2 mL 0.25% inj. Bupivacaine (1 mL on each side) and Group F received 2 μg Kg-1 I.V. fentanyl as 2 mL solution. Assessment of pain was done by FLACC scale and recovery profile by Modified Aldrete Score. Haemodynamic monitoring along with side effects was assessed. Data was analysed using SPSS software (Statistical Package of Social Science) version 17.0. p-value of < 0.05 was considered significant. ResultsPatients receiving block showed significantly better recovery profile (9.22 ± 0.39) vs (8.78 ± 0.61), duration of analgesia (482.59 +93.76) vs (174.13 +84.91) and less mean paracetamol consumption (126.66 +18.70) vs (151.79 +60.03) with comparable haemodynamics and side effects. ConclusionsGreater palatine nerve block provides effective postoperative pain relief after palatoplasty in children compared to I.V. fentanyl. It is safe, easy to perform, and free of complications.