M Johansen1, G Harbo, P Illum. 1. Department of Otolaryngology, University Hospital of Aarhus, Denmark.
Abstract
OBJECTIVE: To investigate the value of preincisional peritonsillar infiltration of bupivacaine hydrochloridebefore tonsillectomy under general anesthesia. DESIGN: Double-blind trial with two groups comparing 0.25% bupivacaine with placebo (normal saline). The patients were followed up for 10 days after surgery. SETTING: Department of Otolaryngology, University Hospital of Aarhus (Denmark). PATIENTS: Men and women 18 to 40 years of age referred to our department for bilateral tonsillectomy, but with no sign of acute infection or suspected malignant neoplasm. Twenty-six patients entered the study; five were excluded for failure to complete the postoperative data; and two, one from each group, had postoperative bleeding. Data from 19 patients were analyzed, nine in the bupivacaine group and 10 in the placebo group. INTERVENTION: One group had 5 mL of 0.25% bupivacaine hydrochloride (Marcaine) infiltrated around each tonsil, the other an identical placebo (normal saline) infiltration. OUTCOME MEASURES: A visual analogue scale was used as the primary efficacy measure. The daily intake of analgesics and a possible weight loss were registered. RESULTS: A notably lower score on the visual analogue scale was found in the bupivacaine group. CONCLUSIONS: Preoperative blocking of nociceptive impulses reduces prolonged postoperative pain, but no reduction in the intake of analgesics was found. Medication was insufficient for the first postoperative days.
RCT Entities:
OBJECTIVE: To investigate the value of preincisional peritonsillar infiltration of bupivacaine hydrochloride before tonsillectomy under general anesthesia. DESIGN: Double-blind trial with two groups comparing 0.25% bupivacaine with placebo (normal saline). The patients were followed up for 10 days after surgery. SETTING: Department of Otolaryngology, University Hospital of Aarhus (Denmark). PATIENTS: Men and women 18 to 40 years of age referred to our department for bilateral tonsillectomy, but with no sign of acute infection or suspected malignant neoplasm. Twenty-six patients entered the study; five were excluded for failure to complete the postoperative data; and two, one from each group, had postoperative bleeding. Data from 19 patients were analyzed, nine in the bupivacaine group and 10 in the placebo group. INTERVENTION: One group had 5 mL of 0.25% bupivacaine hydrochloride (Marcaine) infiltrated around each tonsil, the other an identical placebo (normal saline) infiltration. OUTCOME MEASURES: A visual analogue scale was used as the primary efficacy measure. The daily intake of analgesics and a possible weight loss were registered. RESULTS: A notably lower score on the visual analogue scale was found in the bupivacaine group. CONCLUSIONS: Preoperative blocking of nociceptive impulses reduces prolonged postoperative pain, but no reduction in the intake of analgesics was found. Medication was insufficient for the first postoperative days.
Authors: Klaus Stelter; Joachim Hiller; John Martin Hempel; Alexander Berghaus; Hjalmar Hagedorn; Michaela Andratschke; Martin Canis Journal: Eur Arch Otorhinolaryngol Date: 2010-01-13 Impact factor: 2.503
Authors: Klaus Stelter; John Martin Hempel; Alexander Berghaus; Michaela Andratschke; Christian W Luebbers; Hjalmar Hagedorn Journal: Eur Arch Otorhinolaryngol Date: 2009-01-22 Impact factor: 2.503
Authors: Montasir Junaid; Muhammad Sohail Halim; Maisam Abbas Shiraz Onali; Sadaf Qadeer; Hareem Usman Khan; Naeem Sultan Ali Journal: Int Arch Otorhinolaryngol Date: 2019-11-04