Pre-operative versus post-operative peritonsillar infiltration with local anesthetic on post-tonsillectomy pain

الملخص EN

To compare the efficacy of either preoperative or post¬operative peritonsillar infiltration of local anesthetic upon post tonsillectomy pain, 70patients aged 15 / 40 years sched¬uled for elective tonsillectomy under general anesthesia were divided into three groups.

Six patients were excluded for failure to complete the postoperative data, two patients had post-operative bleeding and two patients developed oti¬tis media on the second day postoperatively.

Twenty patients received peritonsillar infiltration with 0.25 % bupivacaine, twenty received 0.9 % saline and a third group of twenty had peritonsillar infiltration with 0.25 % bupivacaine after completion of surgery but before being awakened from anesthesia.

Significant changes occurred with bupivacaine infiltration in reducing pain during the first 24 hours after surgery.

It is concluded that preoperative and postoperative blocking of nociceptive impulses reduces postoperative pain but causes no reduction in the intake of analgesics.

It is further suggested that the timing of peritonsillar infiltra¬tion with bupivacaine is not of clinical importance and does not affect the quality of postoperative analgesia in a pa¬tient undergoing tonsillectomy.