Post-tonsillectomy pain and bupivacaine, an intra individual design study

ABSTRACT

To compare whether an individual could appreciate the pain relief, if any, in either one of his/her tonsillar fossa topically suffused with a local anaesthetic [bupivacaine]. Randomized controlled trial. Department of ENT/Head and Neck Surgery, Combined Military Hospital, Peshawar, from January to June 2007. Forty-six patients of either gender, aged 10-42 years undergoing tonsillectomy for recurrent tonsillitis were enrolled for this study. At the end of surgery, having secured haemostasis, one tonsillar fossa was randomly packed with a gauze piece soaked in 3 ml of 0.5% bupivacaine for 5 minutes, while the other was not. Effects of postoperative analgesia were assessed using visual analogue scale [VAS] up to 8 hours. Majority of the patients [85%, n=39] failed to experience an appreciable pain relief on the side of local anaesthetic [bupivacaine] application [p=0.006]. Topical application of local anaesthetic [bupivacaine] confers no appreciable pain control in post-tonsillectomy patients