Nerve Block May Reduce Opioid Use After Pediatric Primary Cleft Palate Repair

TUESDAY, Dec. 23, 2025 (HealthDay News) — For pediatric patients undergoing primary cleft palate repair, preoperative ultrasound-guided suprazygomatic maxillary nerve block (SMNB) is associated with a reduction in perioperative morphine consumption, according to a study published online Dec. 6 in the Journal of Craniofacial Surgery.

Nina Wijnants, M.D., from Maastricht University Medical Center in the Netherlands, and colleagues examined the potential association between preoperative ultrasound-guided SMNB and reduced perioperative opioid consumption in pediatric patients (younger than 2 years) undergoing primary cleft palate repair in a retrospective cohort study. Ten patients received SMNB (bilateral ultrasound-guided 0.15 mL/kg of 0.25 percent bupivacaine with epinephrine under general anesthesia); 10 historical controls selected from an existing database did not receive a regional nerve block.

The researchers found that the SMNB group had significantly lower perioperative morphine consumption (median, 0.00 versus 0.75 mg), while no significant difference was seen in tramadol use. No significant differences were seen in secondary outcomes, including additional analgesic use and hospital stay.

“Our study presents preliminary but promising results suggesting that suprazygomatic maxillary nerve block [SMNB] may reduce perioperative opioid consumption in pediatric primary clefts, particularly cleft palate closure,” senior author Rutger M. Schols, M.D., Ph.D., of MosaKids Children”s Hospital in Maastricht, Netherlands, said in a statement.

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