Bali Journal of Anesthesiology · Published 2025-04-01 · DOI 10.4103/bjoa.bjoa_34_25
Background: Effective perioperative pain management is crucial in pediatric patients undergoing palatoplasty. This randomized controlled trial evaluated the effect of a preoperative bilateral sphenopalatine ganglion block (SPGB) using 0.5% bupivacaine on postoperative analgesic requirements and perioperative outcomes. Methods: Fifty children aged six months to three years undergoing palatoplasty were randomized into two groups: Group B (SPGB with 0.5% bupivacaine) and Group C (placebo with normal saline). The primary outcome was the need for rescue analgesia within the first hour post-extubation. Secondary outcomes included intraoperative anesthetic requirements (sevoflurane and fentanyl consumption), intraoperative hemodynamics, extubation time, postoperative pain (FLACC scale), and emergence delirium (PAED scale). Statistical analyses included independent t-tests, the chi-square tests, and repeated measures ANOVA. Results: The need for rescue analgesia within 1 hour was significantly lower in Group B (24%) compared with Group C (64%) (P = 0.004). Group B also demonstrated reduced intraoperative sevoflurane (15.2 ± 2.6 mL vs. 23.5 ± 4.8 mL, P < 0.001), lower fentanyl consumption (2.1 ± 0.4 µg/kg vs. 3.3 ± 0.5 µg/kg, P < 0.001), and shorter extubation times (3.5 ± 0.6 min vs. 8.8 ± 1.4 min, P < 0.001). Postoperative pain and emergence delirium scores were also significantly lower in Group B. Conclusion: Preoperative bilateral SPGB with 0.5% bupivacaine significantly reduces postoperative analgesic needs and improves perioperative outcomes in children undergoing palatoplasty. SPGB is an effective adjunct for enhancing perioperative analgesia in pediatric surgical patients.
Abstract from DOAJ. Public domain (CC0 1.0).
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