Suprazygomatic Maxillary Nerve Block is Associated with Reduced Postoperative Inpatient Opioid Requirement in Patients Undergoing Palatoplasty

Abstract

Objective

The objective of this study was to evaluate the efficacy of the suprazygomatic maxillary nerve block in reducing postoperative inpatient opioid requirements in patients undergoing palatoplasty for cleft palate repair.

Design

Retrospective cohort study

Setting

Tertiary care children's hospital

Patients, Participants

Patients with isolated cleft palate or cleft lip and palate who underwent palatoplasty at our institution between 2006 and 2025.

Interventions

Patients who received the suprazygomatic maxillary nerve block and a controlled cohort of patients who underwent cleft palate repair during the same time period without receiving a nerve block were assessed. Patient demographics, perioperative data, and opioid requirements within the immediate eight hours (in morphine milliequivalents [MME]) following surgery were recorded. Multivariate regression analysis was performed, with significance defined as p < .05.

Main Outcome Measures

Inpatient opioid requirement eight hours following surgery

Results

A total of 470 patients were included, with 235 (50.0%) in the nerve block group and 235 (50.0%) in the group without nerve block. When adjusting for age, sex, Veau class, and surgical approach, use of nerve block was associated with a significantly lower amount of MME administered in the first eight hours following palatoplasty (OR = 0.54, 95% CI [0.34–0.87], p = .011).

Conclusions

The suprazygomatic maxillary nerve block appears to be an effective technique for reducing postoperative inpatient opioid requirements in children undergoing cleft palate repair.