Comparison of Peritonsillar Infiltration of Lidocaine and Bupivacaine for Management of Postoperative Pain of Tonsillectomy
Journal of Otorhinolaryngology and Facial Plastic Surgery,
Vol. 2 No. 2 (2016),
2 March 2016
Page pp. 37-42
Background: Postoperative pain following tonsillectomy is a common problem of this surgical procedure.
Purpose: To compare the effects of preincisional peritonsillar infiltration of lidocaine and bupivacaine on post tonsillectomy pain in patients older than 8 years old.
Methods: A double blind randomized clinical trial was conducted in patients undergoing elective tonsillectomy or adenotonsillectomy. The patients randomly allocated into three groups. Peritonsillar infiltrations with bupivacaine, lidocaine and normal saline were applied in group 1 2 and 3respectively. In 5th, 10th and 20th postoperative hours, the severity of pain was evaluated by visual analogue scale (VAS).
Results: The patients in the bupivacaine group experienced a significantly milder pain in all postoperative hours comparing with the other groups. This effect was more obvious in male sex. The difference in pain sensation between lidocaine and saline groups was not significant.Conclusion: Peritonsillar infiltration of bupivacaine decreases pain in the first post-operative day after tonsillectomy whereas lidocaine does not show a similar effect.
How to Cite
Hydri AS, Nawaid M, Afridi J, Shabbir G. Comparison of Local application versus Infiltration of Bupivacaine for post Tonsillectomy pain in Adults. Ann Pak Inst Med Sci. 2012;8(1):3-5.
Özkiriş M, Kapusuz Z, Saydam L. Comparison of ropivacaine, bupivacaine and lidocaine in the management of post-tonsillectomy pain. International journal of pediatric otorhinolaryngology. 2012;76(12):1831-4.
Egeli E, Harputluoglu U, Oghan F, Demiraran Y, Guclu E, Ozturk O. Does topical lidocaine with adrenaline have an effect on morbidity in pediatric tonsillectomy? International journal of pediatric otorhinolaryngology. 2005;69(6):811-5.
Nikandish R, Maghsoodi B, Khademi S, Motazedian S, Kaboodkhani R. Peritonsillar infiltration with bupivacaine and pethidine for relief of post‐tonsillectomy pain: a randomised double‐blind study. Anaesthesia. 2008;63(1):20-5.
Kasapoglu F, Kaya FN, Tuzemen G, Ozmen OA, Kaya A, Onart S. Comparison of peritonsillar levobupivacaine and bupivacaine infiltration for post-tonsillectomy pain relief in children: placebo-controlled clinical study. International journal of pediatric otorhinolaryngology. 2011;75(3):322-6.
Akoglu E, Akkurt BCO, Inanoglu K, Okuyucu S, Daglı S. Ropivacaine compared to bupivacaine for post-tonsillectomy pain relief in children: a randomized controlled study. International journal of pediatric otorhinolaryngology. 2006;70(7):1169-73.
Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2009.
Nunez DA, Provan J, Crawford M. Postoperative tonsillectomy pain in pediatric patients: electrocautery (hot) vs cold dissection and snare tonsillectomy—a randomized trial. Archives of Otolaryngology–Head & Neck Surgery. 2000;126(7):837-41.
Sun J, Wu X, Meng Y, Jin L. Bupivacaine versus normal saline for relief of post-adenotonsillectomy pain in children: a meta-analysis. International journal of pediatric otorhinolaryngology. 2010;74(4):369-73.
Jebeles JA, Reilly JS, Gutierrez JF, Bradley EL, Kissin I. Tonsillectomy and adenoidectomy pain reduction by local bupivacaine infiltration in children. International journal of pediatric otorhinolaryngology. 1993;25(1-3):149-54.
Jebeles JA, Reilly JS, Gutierrez JF, Bradley EL, Kissin I. The effect of pre-incisional infiltration of tonsils with bupivacaine on the pain following tonsillectomy under general anesthesia. Pain. 1991;47(3):305-8.
Nordahl SHG, Albrektsen G, Guttormsen AB, Pedersen IL, Breidablikk H-J. Effect of bupivacaine on pain after tonsillectomy: a randomized clinical trial. Acta oto-laryngologica. 1999;119(3):369-76.
Heiba M, Atef A, Mosleh M, Mohamed R, El-Hamamsy M. Comparison of peritonsillar infiltration of tramadol and lidocaine for the relief of post-tonsillectomy pain. The Journal of Laryngology & Otology. 2012;126(11):1138-41.
Bean-Lijewski J. Glossopharyngeal nerve block for pain relief after pediatric tonsillectomy: retrospective analysis and two cases of life-threatening upper airway obstruction from an interrupted trial. Anesthesia & Analgesia. 1997;84(6):1232-8.
Karaaslan K, Yilmaz F, Gulcu N, Sarpkaya A, Colak C, Kocoglu H. The effects of levobupivacaine versus levobupivacaine plus magnesium infiltration on postoperative analgesia and laryngospasm in pediatric tonsillectomy patients. International journal of pediatric otorhinolaryngology. 2008;72(5):675-81.
Stuart J, MacGregor F, Cairns C, Chandrachud H. Peritonsillar infiltration with bupivacaine for paediatric tonsillectomy. Anaesthesia and intensive care. 1994;22(6):679-82.
- Abstract Viewed: 387 times
- PDF Downloaded: 375 times