71262
document
Peritonsillar infiltration with levobupivacaine for posttonsillectomy pain relief : does concentration have any effect ? A double-blind randomized controlled clinical study . OBJECTIVE Post-tonsillectomy pain is believed to be mediated by noxious stimulation of C-fiber afferents located in the peritonsillary space , and local anesthetic infiltration to this area may decrease pain by blocking the sensory pathways and thus preventing the nociceptive impulses . We aimed to compare the effects of different concentrations of preincisional peritonsillar levobupivacaine ( 0.25 % and 0.5 % ) infiltration on postoperative pain and bleeding in a placebo-controlled design . PATIENTS AND METHODS After obtaining Institutional Ethics Committee approval , 72 ASA I-II patients between 3 and 12 years of age , scheduled to undergo tonsillectomy were enrolled and randomly assigned to one of the three groups using the sealed envelope technique , as Group I ( Control group ) , Group II , and Group III receiving preincisional bilateral peritonsillar infiltration with saline , 0.25 % levobupivacaine and 0.5 % levobupivacaine , respectively ( 3 mL to each tonsil ) . Pain , fever , dysphagia ; nausea-vomiting and hemorrhage were evaluated at postoperative 0 , 30 , and 60 minutes and 2 , 6 , 12 , and 24 hours . Oral paracetamol was administered at a dose of 15 mg/kg when FLACC score was > 4 . The number of paracetamol administrations within the first 24 hours were recorded . RESULTS The patients in Groups I , II and III defined pain ( FLACC > 4 ) at a rate of 87 % , 60.9 % , and 54.2 % within the postoperative first 24 hours , respectively . The total number of additional analgesic requirements was significantly low in Group II and III when compared with Group I . There was no difference between groups in terms of fever , dysphagia , nausea-vomiting , hemorrhage . CONCLUSIONS Both concentrations ( 0.50 % and 0.25 % ) of levobupivacaine were found to be equally safe and effective during preincisional peritonsillar infiltration in children . NCT number : 02322346 .
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Intervention_Pharmacological
levobupivacaine
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Intervention_Pharmacological
peritonsillar levobupivacaine
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Intervention_Control
placebo-controlled
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Intervention_Control
Control group
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Intervention_Pharmacological
preincisional bilateral peritonsillar infiltration with saline
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Intervention_Pharmacological
0.25 % levobupivacaine
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Intervention_Pharmacological
0.5 % levobupivacaine
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Intervention_Pharmacological
Oral paracetamol
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Intervention_Pharmacological
paracetamol
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Intervention_Pharmacological
analgesic
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Intervention_Pharmacological
levobupivacaine
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Outcome_Pain
pain relief :
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Outcome_Pain
postoperative pain and bleeding
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Outcome_Pain
Pain
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Outcome_Physical
fever
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Outcome_Physical
dysphagia
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Outcome_Physical
nausea-vomiting
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Outcome_Other
number of paracetamol administrations
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Outcome_Pain
pain
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Outcome_Other
additional analgesic requirements
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Outcome_Physical
fever
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Outcome_Physical
dysphagia
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Outcome_Physical
nausea-vomiting
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Outcome_Physical
hemorrhage
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Outcome_Other
safe and effective
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Participant_Condition
posttonsillectomy pain
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Participant_Condition
Post-tonsillectomy pain
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Participant_Sample-size
72
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Participant_Age
between 3 and 12 years of age
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Participant_Age
children