Effect On Postoperative Pain After Topical Applcation Of Local Anesthtcs In The Tonsillar Fossa After Tonsillecomy

ABSTRACT

Background: Tonsillectomy is one of the most commonly performed surgeries in ENT practice. Despite improvements in anesthestic and surgical techniques, post tonsillectomy morbidities continue to be a significant clinical concern. Pain is the cause of most of the post-operative morbidity after tonsillectomy. An effective pain therapy to block or modify the physiological responses to stress has become an essential component of modern pediatric anesthesia and surgical practice.

Aim: The present study compares the resultsbetween the effects of Lidocaine 2% infiltration, Lidocaine 10 % spray and Bupivacaine 0.5% spray in tonsillar bed after tonsillectomy on postoperative pain.

Materials and Methods:120 patients aged 5-18 years who were candidates for tonsillectomy at Otorhinolaryngology department of Alexandria Main University Hospital. Patients were randomly divided into three groups, 40 patients each. Group A received Lidocaine 2% (Xylocaine) peritonsillar infiltration 2 cc in one tonsillar bed and posterior pillar, Group Breceived Lidocaine 10%(Xylocaine) spray 2 puff in one tonsillar bed,Group C received Bupivacaine 0.5% (Marcaine) solution 2cc in one tonsillar bed spray by syringe and the other tonsillar bed in each group receives pack with similar amount of normal saline for five minutes as a control group after tonsillectomy before recovery from anaesthsia.

Results: There was no statistical difference between the three studied groups as regards age and sex. There is significant statistical difference according to the frequency of throat pain and ear pain by comparing cases and controls of each groupwithin 1^st 24 hours after surgery. It appears that increased frequency of postoperative throat pain and ear pain is present with control side (saline).

Conclusion: Topical application of the tonsillar bed with local anaesthetic after tonsillectomy results in significant reduction of postoperative throat pain and referred otalgia, and should be used during surgery for tonsillectomy.

Keywords: Tonsillectomy; Anesthetics,Local; pain,postoperative

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