Suleiman, Nergis Nina; Luedi, Markus M; Joshi, Girish; Dewinter, Geertrui; Wu, Christopher L; Sauter, Axel R (2024). Perioperative pain management for cleft palate surgery: a systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. (In Press). Regional anesthesia and pain medicine Lippincott Williams & Wilkins 10.1136/rapm-2023-105024
Full text not available from this repository. (Request a copy)BACKGROUND/IMPORTANCE
Cleft palate surgery is associated with significant postoperative pain. Effective pain control can decrease stress and agitation in children undergoing cleft palate surgery and improve surgical outcomes. However, limited evidence often results in inadequate pain control after cleft palate surgery.
OBJECTIVES
The aim of this review was to evaluate the available evidence and to develop recommendations for optimal pain management after cleft palate surgery using procedure-specific postoperative pain management (PROSPECT) methodology.
EVIDENCE REVIEW
MEDLINE, Embase, and Cochrane Databases were searched for randomized controlled trials and systematic reviews assessing pain in children undergoing cleft palate repair published in English language from July 2002, through August 2023.
FINDINGS
Of 1048 identified studies, 19 randomized controlled trials and 4 systematic reviews met the inclusion criteria. Interventions that improved postoperative pain, and are recommended, include suprazygomatic maxillary nerve block or palatal nerve block (if maxillary nerve block cannot be performed). Addition of dexmedetomidine to local anesthetic for suprazygomatic maxillary nerve block or, alternatively, as intravenous administration perioperatively is recommended. These interventions should be combined with a basic analgesic regimen including acetaminophen and nonsteroidal anti-inflammatory drugs. Of note, pre-incisional local anesthetic infiltration and dexamethasone were administered as a routine in several studies, however, because of limited procedure-specific evidence their contribution to pain relief after cleft palate surgery remains unknown.
CONCLUSION
The present review identified an evidence-based analgesic regimen for cleft palate surgery in pediatric patients.
PROSPERO REGISTRATION NUMBER
CRD42022364788.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy |
UniBE Contributor: |
Lüdi, Markus |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1098-7339 |
Publisher: |
Lippincott Williams & Wilkins |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
28 Dec 2023 11:57 |
Last Modified: |
19 Jan 2024 00:16 |
Publisher DOI: |
10.1136/rapm-2023-105024 |
PubMed ID: |
38124208 |
Uncontrolled Keywords: |
Acute Pain Pain Management Pain, Postoperative REGIONAL ANESTHESIA analgesia |
URI: |
https://boris.unibe.ch/id/eprint/190654 |
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