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Indian Journal of Anesthesia and Analgesia

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Role of Intraoperative Topical Application of 0.5% Bupivacaine in Tonsillar Fossa for Postopeartive Analgesia in Tonsillectomy Cases

Yedidi Samyukta, Assistant Professor, Department of Anaesthesiology, Omandurar Government Medical College, Omandurar Govt. Estate Wallajah Raod, Chennai, Tamil Nadu 600002, India. , Meera Rani Nayak1 , Yedidi Samyukta2 , Janani C.3

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Indian Journal of Anesthesia and Analgesia 5(10):p 1668-1672, Oct 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.13

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Abstract

  Context: Tonsillectomy is the second most common surgical procedure performed in pediatric patients. Post­Tonsillectomy pain is regarded as a major morbidity in early post­operative period which delays the oral intake & discharge of patients. Topical application of Local Anesthetic like Bupivacaine at the site of trauma reduces post­operative pain resulting in early oral intake & early discharge unlike local infiltration in which complication rate is high for intravascular injection and convulsions. Settings and Design: Prospective randomized and comparative study of 40 ASA I and II patients of age group 6 to 15 years undergoing tonsillectomy under general anaesthesia. Methods and Material: Patients were divided into two groups randomly, group B (Bupivacaine group) – in which 2 cotton pledgets soaked in 0.1ml/kg of 0.5% Bupivacaine was kept in the tonsillar fossa for 5 minutes and group C (control group) which received 2 cotton pledgets soaked in 0.1ml/kg of 0.9% NaCl and kept in fossa for 5 mins. Statistical Analysis Used: One­way ANOVA was used for analyzing the data. For comparing binomial data like sex and ASA status, Chi square test was used. Results: The group with topical bupivacaine had less tonsillar fossa pain and requested postoperative analgesics very lately or not till discharge Conclusion: We conclude that topical application of cotton pledget soaked in 0.5% bupivacaine in tonsillar fossa for 5 minutes is effective in providing relief of post tonsillectomy pain and promote recovery. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.13

Keywords

Post Tonsillectomy Pain; Topical 0.5% Bupivacaine; Intraoperative; Cotton Pledget; VAS Score.

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