Nerve block for pain management in pediatric patients undergoing cleft lip and palate repair: A systematic review and network meta-analysis

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2025-03-18 DOI:10.1016/j.bjps.2025.03.036

Nawaf Alhindi , Houriah Nukaly , Lina Abdulrahman , Sarah Alzolaibani , Mousa Akkour , Abdulaziz Abumelha , Deemah Alhuraish , Razan Albrahim , Reemah AlQahtani , Sami I. Alissa

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Abstract

Background

Cleft lip and palate, a common congenital anomaly, occurs in approximately 1 in every 1000–1500 births. Effective postoperative pain management in pediatric patients undergoing repair for cleft lip and palate remains a challenge. Therefore, this systematic review and network meta-analysis aimed to assess the effectiveness of nerve block in controlling postoperative pain compared to other methods in pediatric patients who underwent cleft lip and palate repair.

Methods

This review adhered to the preferred reporting items for systematic reviews and meta-analysis guidelines. A comprehensive search was conducted across multiple databases, including Embase, MEDLINE, Cochrane, and SCOPUS, without time frame limitation.

Results

A total of 8 randomized controlled trials comprising 550 patients were included. The findings of the study indicate that dexmedetomidine provided longer duration of nerve block (incremental value = 6.33, CI 95%, 1.49: 11.16) compared to the control. Thus, the probability of dexmedetomidine achieving longer nerve block is 89.98%. This was followed by fentanyl and pethidine.

Conclusion

This study supports the efficacy and safety of nerve blocks, particularly with dexmedetomidine, for postoperative pain management in pediatric cleft lip and palate repair. Adjuvant-enhanced nerve blocks offer extended pain relief and reduce the reliance on opioids.

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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.