Effect of Infraorbital Block by Bupivacaine and Bupivacaine-Ketamine against Analgesics duration in Labioplasty patients

Abstract

Labioplasty discomfort can be prevented by inhibiting the infraorbital nerve. Ketamine can be utilized as an adjuvant to lengthen the duration of analgesia in the infraorbital block when bupivacaine is used for infraorbital blocks within a relatively short period. This study aimed to assess the analgesic duration of bupivacaine and bupivacaine-ketamine on the infraorbital block in patients undergoing labioplasty, using the FLACC pain score.The research is a prospective approach, randomized, controlled clinical experiment with double-blinding. Thirty subjects, 3-12month-old children with ASA I and II status, received labioplasty surgery. Subjects were administered 1mL of each infraorbital block with 0.25% Bupivacaine and 0.25% Bupivacaine with Ketamine 0.5mg/kg BW to each group. The Paired T-test was used to compare subject characteristics, while the Independent T-test was used to compare heart rate. Chi-square (Fisher's exact) analysis revealed a significance level of p 0.005 for the FLACC value comparison. All statistical test results were examined with SPSS version 25.0. In the Bupivacaine group, there was an increase in mild pain within 4-5hours (7:46.7%); by 6 hours, there was an increase in mild pain in all 15 participants. At eight hours, it progressed to moderate pain (7:46.7%) with 496 minutes of analgesia and light pain (8:53.7%). The individuals in the Bupivacaine-Ketamine group had pain between 5-8 hours. Six patients (40%) with a pain-free analgesia duration of 1.440 minutes and nine (60%) with a minor pain status had FLACC values 4 during 24-hour observations.Bupivacaine and Bupivacaine-Ketamine have no side effects and no change in heart rate. Combining Bupivacaine with Ketamine has a more prolonged postoperative analgesic effect (24 hours) than the bupivacaine group in the infraorbital block in labioplasty patients (8 hours).