Pre-incisional infiltration for pediatric tonsillectomy: A randomized double-blind clinical trial
Tonsillectomy is frequently associated with post-operative pain of considerable duration. The aim of the current study is to corroborate our previous observational data by conducting a prospective double-blind placebo-controlled randomized clinical trial to determine the potential effect of pre-inci...
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Published in | International journal of pediatric otorhinolaryngology Vol. 69; no. 10; pp. 1333 - 1341 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Ireland
Elsevier Ireland Ltd
01.10.2005
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Subjects | |
Online Access | Get full text |
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Summary: | Tonsillectomy is frequently associated with post-operative pain of considerable duration. The aim of the current study is to corroborate our previous observational data by conducting a prospective double-blind placebo-controlled randomized clinical trial to determine the potential effect of pre-incision infiltration of local anesthesia on post-operative pain after tonsillectomy.
Randomized double-blind controlled clinical trial.
Tertiary care facility in Beirut, Lebanon.
Ninety patients who underwent tonsillectomy allocated evenly in three groups.
Pre-incision infiltration of 1.5 local anesthetic mixture in each tonsil was performed in conjunction with general anesthesia (infiltration,
n
=
30). Pre-incision infiltration of 1.5
ml of 0.9% of normal saline was applied with general anesthesia (placebo,
n
=
30). GA received only general anesthesia.
Post-operative pain at rest, eating soft diet, jaw opening at 0, 6, 12, and once daily for the 10-day follow-up period, hemodynamic stability, hospital stay, parent and surgeon satisfaction, ear pain and analgesics consumption were assessed.
Hemodynamic stability was maitained during pre, per and post-operation. 93.1% of infiltration group left the hopital the same day compared to 60% in placebo groups and 41.4% in general anesthesia group (
p
=
0.001). Surgeon's satisfaction was significantly higher in infiltration group compared to placebo and general anesthesia groups (
p
=
0.001). Parent's satisfaction was significantly higher in infiltration group (89.65%) compared to general anesthesia group (13.8%) and placebo group (36.7%) (
p
=
0.001). The average pain scores at rest, on jaw opening and when eating soft diet were significantly lower in infiltration group compared to placebo group and general anesthesia group (
p
<
0.05). Analgesic consumption in placebo and general anesthesia groups were significantly higher compared to infiltration group (
p
<
0.05).
This modified pre-incision infiltration of anesthetic mixture combined with general anesthesia reduces significantly post-tonsillectomy pain in children and provides a more rapid return to normal activity compared to general anethesia alone or in combination with a placebo infiltration. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23 |
ISSN: | 0165-5876 1872-8464 |
DOI: | 10.1016/j.ijporl.2005.03.020 |