Effect of bilateral intranasal transmucosal sphenopalatine ganglion block on intraoperative fentanyl requirement in children undergoing palatoplasty under general anaesthesia - A randomised, double-blinded, comparative study.

IF 2.9 Q1 ANESTHESIOLOGY

Indian Journal of Anaesthesia Pub Date : 2025-05-01 Epub Date: 2025-04-16 DOI:10.4103/ija.ija_1186_24

Yellala Srinivas, Shubhi Singhal, Rupesh Yadav, Devang Bharti

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引用次数: 0

Abstract

Background and aims: Palatoplasties are extremely painful surgeries commonly performed in children; hence, providing excellent analgesia for these surgeries is crucial. This study aims to evaluate the effect of bilateral intranasal transmucosal sphenopalatine ganglion (SPG) block on intraoperative fentanyl requirement in children undergoing palatoplasty under general anaesthesia (GA).

Methods: Thirty American Society of Anesthesiologists physical status (PS) I and II patients, aged 6 months-12 years, scheduled to undergo palatoplasty, were randomised to two groups. After induction of anaesthesia, patients in Group T received bilateral SPG block using 0.5% bupivacaine-soaked cotton-tip applicators, while patients in Group C received standard anaesthesia care. The primary outcome was intraoperative fentanyl requirement, and secondary outcomes were intraoperative haemodynamics and post-extubation Paediatric Anaesthesia Emergence Delirium (PAED) scale scores at 5 and 10 min, respectively.

Results: The mean intraoperative fentanyl consumption was 26.73 [standard deviation (SD): 10.19)] [95% confidence interval (CI): 20.38, 33.08] μg in Group T compared to 34.47 (SD: 12.73) (95% CI: 27.20, 41.74) μg in Group C (P = 0.008). Heart rate and mean arterial pressure were lower in Group T as compared to that in Group C (P < 0.05). PAED scale scores were recorded to be 7.33 (SD: 1.50) (95% CI: 6.47, 8.19) and 6.00 (SD: 1.31) (95% CI: 5.30, 6.70) for Group T, and 15.53 (SD: 0.74) (95% CI: 15.13, 15.93) and 14.07 (SD: 0.59) (95% CI: 13.75, 14.39) for Group C at 5 and 10 min, respectively (P < 0.001).

Conclusion: SPG block causes a significant reduction in intraoperative fentanyl consumption, stabilises haemodynamics, and facilitates smoother recovery of children undergoing palatoplasty under GA.

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双侧鼻经黏膜蝶腭神经节阻滞对全麻下腭成形术患儿术中芬太尼需求量的影响——一项随机、双盲、比较研究。

背景和目的：腭裂成形术是一种非常痛苦的手术，常见于儿童；因此，为这些手术提供良好的镇痛是至关重要的。本研究旨在评估双侧鼻经黏膜蝶腭神经节（SPG）阻滞对全麻（GA）下腭裂成形术患儿术中芬太尼需求量的影响。方法：30例年龄6个月~ 12岁的美国麻醉医师协会物理状态（PS） I和II期拟行腭裂成形术患者随机分为两组。麻醉诱导后，T组患者采用0.5%布比卡因浸棉头应用双侧SPG阻滞，C组患者采用标准麻醉护理。主要结果是术中芬太尼的需要量，次要结果是术中血流动力学和拔管后儿科麻醉出现性谵妄（PAED）评分分别在5和10分钟。结果：T组术中芬太尼平均用量为26.73[标准差（SD）： 10.19][95%可信区间（CI）： 20.38, 33.08] μg， C组为34.47 (SD: 12.73) (95% CI: 27.20, 41.74) μg （P = 0.008）。T组心率、平均动脉压明显低于C组（P < 0.05）。T组PAED评分分别为7.33 (SD: 1.50) （95% CI: 6.47, 8.19）和6.00 (SD: 1.31) (95% CI: 5.30, 6.70)， C组在5和10分钟分别为15.53 (SD: 0.74) （95% CI: 15.13, 15.93）和14.07 (SD: 0.59) (95% CI: 13.75, 14.39) （P < 0.001）。结论：SPG阻滞可显著减少术中芬太尼的消耗，稳定血流动力学，促进腭成形术患儿更顺利的恢复。

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