Suprazygomatic Maxillary Nerve Block for Postoperative Pain Management in Cleft Lip and Palate Surgery.

Introduction: Cleft lip and palate are among the most common congenital defects and their surgical correction is associated with significant postoperative pain, the use of high-dose opioids, and prolonged hospital stay.

Objective: To evaluate the efficacy of suprazygomatic maxillary nerve block for postoperative pain management after cleft lip and palate surgery. The primary objective was to evaluate postoperative pain. Secondary objectives included description of perioperative analgesia and need for opioids, perioperative corticosteroid therapy, reintroduction of oral intake, and hospital length of stay.

Methods: Retrospective observational study that included patients undergoing surgery for cleft lip and palate at the Vall d'Hebron University Hospital between February 2022 and September 2024 who received suprazygomatic nerve block. Main study variables included nonopioid drug and opioid use, adjuvant analgesic administration, pain evaluation scales, time to oral intake onset, and length of hospital stay. Statistical analysis was based on the description of mean, median, and quartile values using Student t test with a P-value of <0.05. Qualitative variables were analyzed by comparing proportions with a 95% confidence interval.

Results: In 97% of cases, pain was adequately managed using nonopioid analgesia, and no patients required morphine for rescue analgesia. Intraoperative corticosteroids were administered in 92.5% of instances. Early oral intake onset was achieved in 86.11% of cases. The mean hospital stay duration was 51.06 hours.

Conclusions: The results support suprazygomatic block as an effective technique for postoperative pain management in cleft defect surgery. It facilitates rapid recovery, early oral intake, and a reduction in hospital stay length.