Background: Cleft lip and palate, a common congenital anomaly in plastic surgery, occur in approximately one in every 1000 newborns. Effective postoperative pain management in pediatric patients undergoing repair for cleft lip and palate remains a challenge. Therefore, this systematic review and meta-analysis aim to assess the effectiveness of nerve block in controlling postoperative pain compared to other methods in pediatric patients undergoing cleft lip and palate repair. Methods: This systematic literature review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines . A comprehensive search was conducted across multiple databases, including Embase, MEDLINE, Cochrane, and SCOPUS, without timeframe limitation. Results: The findings of the study indicate that dexmedetomidine achieved the longest duration of nerve block at 89.98%. This was followed by fentanyl (64.12%) and pethidine (51.62%), which also demonstrated significant durations of nerve block. Clonidine exhibited a moderate rate of nerve block at 29.62%. In contrast, the control group exhibited the lowest rate of block at 14.65%. Conclusion: Our systematic review and meta-analysis support the efficacy and safety of nerve blocks, particularly with dexmedetomidine, for postoperative pain management in pediatric cleft lip and palate repair. Adjuvant-enhanced nerve blocks offer extended pain relief and reduce reliance on opioids. Further research and standardized protocols are needed for broader implementation.

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