Question of the Month

Written by:
Sam Nia, MD
UMass Memorial Medical Center, Worcester, MA

You are covering the pediatric acute pain/ regional service and are called to the bedside in the holding area to evaluate a 7 month old female who is scheduled to undergo a right cleft lip and cleft palate repair. The patient’s parents are extremely concerned about perioperative opiate use for this patient and would prefer the patient receive the least amount of opiates possible. The patient has no other significant medical and prenatal history. You are asked if there are any regional anesthesia options available for their child. Which regional technique, if any, could be used in this case?

A. Sphenopalatine Ganglion block using lidocaine-soaked pledgets in the nares

B. Glossopharyngeal nerve blocks using landmark technique

C. Suprazygomatic Maxillary Nerve blocks with ultrasound guidance

D. There is no regional technique that could help in this situation