A comparison of pre-operative and post-operative use of 10% lignocaine aerosol for post-tonsillectomy pain relief in paediatric patients.

Background: Tonsillectomy surgery is most commonly carried out in paediatric age group. Pain relief after tonsillectomy in children remains a dilemma for anaesthesia. Rapid recovery from anaesthesia and return of protective relflexes are desirable earliest. There are conventional methods for pain relief post-tonsillectomy but use of local anaesthetic agents provide pain relief without any adverse effect. Hence we carried out our study in 4-12 years of age group and compare efficacy of pre-operative and post-operative 10% lignocaine aerosol for post-tonsillectomy pain relief. Methods: After institutional approval and informed consent 75 ASA I AND II children in 4-12 years of age group undergoing tonsillectomy were taken. In group A children did not receive any local anaesthetic whereas in group B children received 10% lignocaine aerosol pre-operative 3 minutes prior tonsillectomy and group C children received post-tonsillectomy aerosol in tonsillar fossa raw area. Anaesthetic management was standardized. Post-operative pain assessment done via behavioural scale. Results: The mean age, weight and duration of surgeries were not significantly different when compared in all three groups. In both study group B and C duration of analgesia is comparable in postoperative period. In both group no analgesia required upto 3 hours after surgery. In group C recovery was delayed compared to group B. Conclusions: The use of 10% lignocaine aerosol is easy, safe and effective method for post-tonsillectomy pain relief in paediatrics.

Clinical Comparison of Post-Tonsillectomy Pain : Tonsillectomy Using Cold Instrument Versus Tonsillectomy Using Electrocautery

BACKGROUND AND OBJECTIVES: Tonsillectomy is one of the most common operations in otolaryngology and is performed with various surgical techniques. It seems that there is no superior technique regarding post-tonsillectomy pain. We attempted to identify preferable methods of tonsillectomy in clinical practice by comparing the levels of postoperative pain. MATERIALS AND METHODS: Between June 2009 and Jan 2010, 80 cases of tonsillectomy were performed. In Group A (age : 10-15 years, 40 cases), 20 cases involved tonsillectomy via snare. The other 20 underwent tonsillectomy using electrocautery. The same surgical division was applied in Group B (25-40 ages, 40 cases). All tonsillectomies were performed under general anesthesia by the same surgeon. RESULT: The mean duration of postoperative pain after tonsillectomy by snare and tonsillectomy by electrocautery in Group A was 5.2+/-2.1 and 6.7+/-3.7, respectively. The mean duration of postoperative pain after tonsillectomy by snare and tonsillectomy by electrocautery in Group B was 7.4+/-1.4 and 10.8+/-3.2, respectively. The results indicate that electrocautery is the more painful method of the two tested methods. The difference in post-tonsillectomy pain was statistically significant between the surgical methods. CONCLUSION: It seems that snare tonsillectomy is a useful method for reducing post-tonsillectomy pain compared with that after electrocautery tonsillectomy.