Inclusion of pethidine in lidocaine for infiltration improves analgesia following tonsillectomy in children

• Published in: Acta anaesthesiologica Scandinavica Vol. 41; no. 2; pp. 214 - 217
• Main Authors: ELHAKIM, M., SALAM, A. Y. ABDUL, EID, A., KASCHEF, N., MOSTAFA, B. E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.1997; Blackwell
• Subjects: Analgesics; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - adverse effects; Anesthesia, Local; anesthetics; Anesthetics, Local - administration & dosage; Anesthetics, Local - adverse effects; Biological and medical sciences; Child; Child, Preschool; children; Double-Blind Method; Humans; Lidocaine - administration & dosage; Lidocaine - adverse effects; local: lidocaine; Medical sciences; Meperidine - administration & dosage; Meperidine - adverse effects; Neuropharmacology; opioid; opioid: pethidine; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - prevention & control; pain: postoperative; pediatric; peripheral; Pharmacology. Drug treatments; Premedication; receptor; surgery; Tonsillectomy; Human; Postoperative; Pethidine; Opiates; Narcotic analgesic; Local anesthetic; Analgesia; Regional anesthesia; Pain; Tonsillectomy; Surgery; ENT disease; Infiltration; Lidocaine; Child
• DOI: 10.1111/j.1399-6576.1997.tb04668.x
• ISSN: 0001-5172

Background:Previous work has demonstrated that pethidine exerts local anaesthetic effects on peripheral nerves in vivo. We examined the effects of infiltration anaesthesia by a combination of pethidine and lidocaine on post‐tonsillectomy pain and restlessness in children. Methods:Eighty children were randomly allocated to receive peritonsillar infiltration postoperatively with 3 ml of lidocaine 2% (1.5 ml on each side) combined with either 0.1 ml pethidine, 10 mg · ml‐1, (pethidine group) or 0.1 ml normal saline (control group). Pain and behaviour were assessed at 1, 3, 6 and 12 h postoperatively and on the following morning by the patients and by a nurse blinded to previous treatment. Results: Patients in the pethidine group had lower pain scores than those in the control group at rest as well as swallowing during the whole observation period (P < 0.05). Paracetamol was given to 34/40 children in the control group and to 6/40 children in the pethidine group. The corresponding figures for pethidine administration were 6/40 and 0/40, respectively. Patients in the pethidine group displayed a more rapid return to calm wakefulness than those in the control group (P <0.01). Conclusions: Inclusion of a low dose of pethidine in lidocaine for tonsillar infiltration improves pain relief after tonsillectomy in children.