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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2020; 24(01): e62-e67
DOI: 10.1055/s-0039-1684037
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Intraoperative Use of Analgesics in Tonsillar Fossa and Postoperative Evaluation with Visual analogue Scale Scores—A Prospective, Randomized, Placebo-Controlled, Double-Blind Clinical Trial

Montasir Junaid 
1   Department of Otolaryngology-Head and Neck Surgery, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudia Arabia
,
Muhammad Sohail Halim
2   Byers Eye Institute, Stanford University, Palo Alto, CA, United States
,
Maisam Abbas Shiraz Onali
3   Department of Otorhinolaryngology-Head and Neck Surgery, Jinnah Medical College and Hospital, Karachi, Pakistan
,
Sadaf Qadeer
4   Department of Otorhinolaryngology-Head and Neck Surgery, Sir Syed College of Medical Sciences for girls, Karachi, Pakistan
,
Hareem Usman Khan
5   Department of Cardiology, Shifa Intersternal Hospital, Islamabad, Pakistan
,
Naeem Sultan Ali
6   Department of Otolaryngology-Head and Neck Surgery, The Aga Khan Hospital, Dar-es-salaam, Tanzania
› Author Affiliations
Further Information

Publication History

24 November 2018

17 February 2019

Publication Date:
04 November 2019 (online)

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Abstract

Introduction Posttonsillectomy pain results in significant morbidity to the patients. There is a disagreement in the literature regarding the use of local anesthetics during tonsillectomy. The aim of this placebo-controlled, double-blind study is to evaluate the effect of peritonsillar administration of local anesthetics.

Objective To evaluate the role of intraoperative use of analgesics in tonsillar fossa and postoperative evaluation with visual analogue scale (VAS) scores in achieving pain relief after tonsillectomy procedure

Methods In this study, 180 patients were randomized to 1 of the 6 groups: bupivacaine infiltration, lidocaine infiltration, normal saline infiltration, bupivacaine packing, lidocaine packing, and normal saline packing. Pain caused by speaking, swallowing, and on rest was assessed using VAS at 4, 8, 12, 16 hours, and at discharge.

Results Significant analgesia was obtained in patients who received bupivacaine infiltration and packing compared with placebo (p < 0.05). The majority of the study subjects had no postoperative complications, and patients receiving bupivacaine infiltration required less additional analgesics in the first 24 hours after surgery.

Conclusion We advocate the use of bupivacaine infiltration or packing immediately following the procedure to achieve adequate postoperative analgesia.

Keywords

tonsillectomy - pain - analgesia

Supplementary Material