RELIEF OF POST-TONSILLECTOMY PAIN BY TOPICAL APPLICATION OF BUPIVACAINE

Abstract

Objective: To determine the relief of pain after tonsillectomy by application of topical 0.5% bupivacaine. Methodology: This prospective single-blind study was conducted at Departments of ENT, Mufti Mehmood MemorialTeaching Hospital and District Headquarter Teaching Hospital, Dera Ismail Khan from January 2011 to June 2012. Subjectsof either sex, aging 10-35 years with history of recurrent episodes of acute tonsillitis were included. Those withadenotonsillectomy, with history of acute tonsillitis within three weeks, bleeding diathesis, suspicious of malignancy,or hypersensitivity to bupivacaine were excluded. Subjects were divided into group 1 (treatment group) and 2 (controlgroup) of 48 patients each on convenient sampling method. Patients in group 1 received a topical application of bupivacainegauze soaked in 5 ml of 0.5% bupivacaine solution for five minutes in both tonsillar fossae while patients ingroup 2, received nothing. The post operative pain score was assessed on Visual Analogue Scale (VAS) and comparedbetween the groups at 1, 3 and 8 hours. Results: Out of 96 subjects (48 in each group), 56 (58.3%) were male and 40 (41.7%) female. Mean Pain Score was5.27±2.811 in group 1 & 6.02±2.914 group 2 at 1 hour (p=0.203); 4.81±2.750 in group 1 & 5.60±2.944 group 2 at 3hour (p=0.177) and 4.35±2.605 in group 1 & 5.08±2.901 group 2 at 8 hour (p=0.198). Conclusion: Topical application of 0.5% bupivacaine provides no significant pain relief in post-tonsillectomy patientsin first 8 hours. Key Words: Bupivacaine topical, Post-tonsillectomy pain, Visual Analogue Scale. This article may be cited as: Khan MI, Shah SF, Muhammad, Iqbal K. Relief of post-tonsillectomy pain by topicalapplication of bupivacaine. Khyber Med Univ J 2012; 4(4): 183-186.