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
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 f...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-05-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_1186_24 |
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| _version_ | 1849314971986427904 |
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| author | Yellala Srinivas Shubhi Singhal Rupesh Yadav Devang Bharti |
| author_facet | Yellala Srinivas Shubhi Singhal Rupesh Yadav Devang Bharti |
| author_sort | Yellala Srinivas |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-1fa12c8472fd4a4baa2235f5bbdc117d |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-1fa12c8472fd4a4baa2235f5bbdc117d2025-08-20T03:52:16ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172025-05-0169547147610.4103/ija.ija_1186_24Effect of bilateral intranasal transmucosal sphenopalatine ganglion block on intraoperative fentanyl requirement in children undergoing palatoplasty under general anaesthesia – A randomised, double-blinded, comparative studyYellala SrinivasShubhi SinghalRupesh YadavDevang BhartiBackground 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.https://journals.lww.com/10.4103/ija.ija_1186_24airway extubationanalgesiaanaesthesiabupivacaineemergence deliriumfentanylpalatoplastysphenopalatine ganglion block |
| spellingShingle | Yellala Srinivas Shubhi Singhal Rupesh Yadav Devang Bharti 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 Indian Journal of Anaesthesia airway extubation analgesia anaesthesia bupivacaine emergence delirium fentanyl palatoplasty sphenopalatine ganglion block |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | airway extubation analgesia anaesthesia bupivacaine emergence delirium fentanyl palatoplasty sphenopalatine ganglion block |
| url | https://journals.lww.com/10.4103/ija.ija_1186_24 |
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