Comparison of the postoperative analgesic effects of bupivacaine and ropivacaine in infraorbital nerve block anesthesia for cheiloplasty in infants

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-05-03 DOI:10.1016/j.ijporl.2025.112373

Wenjie Zhou , Yilin Li , Nan Lin , Zhiyu Cai , Chuanqing Mao , Yongzhen Lai , Meng Lu

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Abstract

Obejective

This prospective study aimed to evaluate the analgesic efficacy of ropivacaine and bupivacaine for infraorbital nerve block following cheiloplasty. Additionally, it investigated the safety and feasibility of these agents in infants and young children.

Methods

Participants were divided into three groups: Control (physiological saline), Group L (ropivacaine), and Group B (bupivacaine). Bilateral infraorbital nerve block anesthesia was performed at the beginning of surgery, followed by general anesthesia for the procedure. Postoperative pain was scored using the FLACC scale.

Results

Group B had a significantly lower heart rate post-surgery compared to the other groups (P < 0.05). FLACC pain scores at 30 min, 1 h, and 4 h post-surgery were significantly lower in Groups L and B compared to the control group (P < 0.05). Side effects included edema, hematoma, nausea, vomiting, cyanosis, and convulsions, with no adverse reactions in the control group. Group L had one case of lip cyanosis and convulsions, and Group B had one case of nausea and vomiting. No significant differences were found in age, weight, and surgical time among the three groups (P > 0.05).

Conclusions

Ropivacaine showed similar analgesic effects to bupivacaine but with higher safety for postoperative pain relief in cleft lip repair in infants and young children, suggesting its clinical utility.

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布比卡因与罗哌卡因眶下神经阻滞麻醉对婴幼儿唇腭裂术后镇痛效果的比较

目的观察罗哌卡因和布比卡因对颧骨成形术后眶下神经阻滞的镇痛效果。此外，它还调查了这些药物在婴幼儿中的安全性和可行性。方法将受试者分为3组：对照组（生理盐水）、L组（罗哌卡因）和B组（布比卡因）。手术开始时进行双侧眶下神经阻滞麻醉，随后进行全身麻醉。术后疼痛采用FLACC评分法进行评分。结果B组患者术后心率明显低于其他组(P <；0.05)。术后30 min、1 h、4 h FLACC疼痛评分均明显低于对照组(P <；0.05)。副作用包括水肿、血肿、恶心、呕吐、发绀、抽搐，对照组无不良反应。L组唇部发绀惊厥1例，B组恶心呕吐1例。三组患者的年龄、体重、手术时间均无显著差异(P >；0.05)。结论罗哌卡因用于婴幼儿唇裂修复术后疼痛的镇痛效果与布比卡因相似，但安全性更高，具有临床应用价值。

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.