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Background and Aims Cleft lip and palate (CLP) is a common congenital abnormality necessitating early surgical intervention. Palatoplasty, aimed at restoring normal anatomy, poses postoperative challenges including pain and complications. Traditional pain management with opioids and NSAIDs presents risks, prompting exploration of regional nerve blocks. This study compares the efficacy of sphenopalatine ganglion block (SPGB) and palatal block for postoperative analgesia in children with cleft palate undergoing palatoplasty. The aim is to compare SPGB and palatal block efficacy on postop- analgesia .Primary objectives include assessing postoperative analgesia using FLACC score. Secondary objectives was to evaluate need of rescue analgesia need and parental satisfaction.

Methods This is prospective randomized controlled study . A sample size of 50 (25 per group) was calculated. Children aged 1-5 years with cleft palate meeting inclusion criteria were randomized into two groups: palatal block (Group A) and SPGB (Group B). Both blocks were given after administration of general anaesthesia. Postoperative analgesia was assessed using FLACC score and parental satisfaction was assessed using Likert scale.

Results Result shows postoperative pain using the FLACC scale scores were lower significantly in Group B at various time points (0, 3, 6, 9, and 12 hours post-operatively) compared to Group A (p<0.001 ). Group B requiring significantly less rescue analgesia compared to Group A(p=0.001). Parental satisfaction, assessed on a Likert scale, was significantly higher in Group B compared to Group A (p=0.004).

Conclusions Regarding optimal pain management strategies for children undergoing palatoplasty sphenopalatine ganglion block provide better postoperative analgesia along with parental satisfaction than palatal block.