{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T02:40:12Z","timestamp":1778899212618,"version":"3.51.4"},"reference-count":55,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>To analyze whether the choice of intraoperative local anesthetic for cleft lip repair is associated with the amount of perioperative narcotic utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Hospitals participating in the Pediatric Health Information System.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Primary cleft lip repairs performed in the United States from 2010 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Local anesthesia injected\u2014treatment with lidocaine alone, bupivacaine alone, or treatment with both agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Perioperative narcotic administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>During the study interval, 8954 patients underwent primary cleft lip repair. Narcotic utilization for unilateral ( P\u2009&lt;\u2009.001) and bilateral ( P\u2009=\u2009.004) cleft lip repair has decreased over the last 5 years. Overall, 21.8% (n\u2009=\u20091950) of infants were administered perioperative narcotics for cleft lip repair, such that 14.3% (n\u2009=\u20091282) required narcotics on POD 0, and 7.2% (n\u2009=\u2009647) required narcotics on POD 1. In this study, 36.5% (n\u2009=\u20093269) patients received lidocaine, 22.0% (n\u2009=\u20091966) patients received bupivacaine, and 19.7% (n\u2009=\u20091762) patients received both local anesthetics. Administration of any perioperative narcotic was significantly lower in patients receiving both lidocaine and bupivacaine than those receiving only lidocaine ( P\u2009=\u2009.001, 17.5% vs 21.7%) or only bupivacaine ( P\u2009&lt;\u2009.001, 17.5% vs 22.9%). Narcotic utilization on the day of surgery was significantly lower in patients receiving both lidocaine and bupivacaine than those receiving only lidocaine ( P\u2009&lt;\u2009.001, 11.5% vs 15.1%) or only bupivacaine ( P\u2009=\u2009.004, 11.5% vs 14.6%). Narcotic utilization on the first postoperative day was significantly lower in patients receiving both lidocaine and bupivacaine than those receiving only bupivacaine ( P\u2009=\u2009.009, 5.9% vs 8.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In children undergoing cleft lip repair, local anesthetic combination of lidocaine and bupivacaine is associated with decreased perioperative narcotic use compared to lidocaine or bupivacaine alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656221093945","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T01:58:26Z","timestamp":1650333506000},"page":"1157-1165","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Narcotic Utilization After Cleft Lip Repair: Does Local Anesthetic Choice Matter?"],"prefix":"10.1177","volume":"60","author":[{"given":"Christopher L","family":"Kalmar","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary D","family":"Zapatero","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mychajlo S","family":"Kosyk","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7112-8114","authenticated-orcid":false,"given":"Jordan W","family":"Swanson","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2827-5471","authenticated-orcid":false,"given":"Jesse A","family":"Taylor","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"bibr1-10556656221093945","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004762"},{"key":"bibr2-10556656221093945","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh042"},{"key":"bibr3-10556656221093945","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.294.6577.920"},{"key":"bibr4-10556656221093945","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198702000-00005"},{"key":"bibr5-10556656221093945","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01419.x"},{"key":"bibr6-10556656221093945","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(87)80461-4"},{"key":"bibr7-10556656221093945","unstructured":"US Food and Drug Administration. 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