Narcotic Utilization After Cleft Lip Repair: Does Local Anesthetic Choice Matter?

This article analyzes whether the choice of intraoperative local anesthetic—lidocaine alone, bupivacaine alone, or a combination of both—is associated with perioperative narcotic use in children undergoing primary cleft lip repair in the United States from 2010 to 2020. Using data from the Pediatric Health Information System, the study found that patients receiving both lidocaine and bupivacaine had significantly lower perioperative narcotic requirements compared to those receiving either anesthetic alone, with reductions observed on the day of surgery and the first postoperative day. Additionally, narcotic use after cleft lip repair has decreased over the past five years, and sociodemographic factors influenced anesthetic choice and narcotic prescribing patterns. The study concludes that combining lidocaine and bupivacaine may optimize pain control and reduce opioid exposure in this population, though prospective multicenter studies are needed to confirm these findings.