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...

Full description

Saved in:
Bibliographic Details
Published inInternational journal of pediatric otorhinolaryngology Vol. 69; no. 10; pp. 1333 - 1341
Main Authors Naja, M.Z., El-Rajab, M., Kabalan, W., Ziade, M.F., Al-Tannir, M.A.
Format Journal Article
LanguageEnglish
Published Ireland Elsevier Ireland Ltd 01.10.2005
Subjects
Online AccessGet full text

Cover

Loading…
More Information
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.
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