Armaghane Danesh Bimonthly Journal (Oct 2020)
Comparing the Effect of Topical Injection of Bupivacaine with Lidocaine-Epinephrine Combination on Pain after Tonsillectomy
Abstract
Background & aim: Pain is the most important complaint of children after tonsillectomy. Thus, poor relief will lead to complications. Therefore, the aim of the present study was to determine and compare the effect of topical injection of bupivacaine with lidocaine-epinephrine combination on pain after tonsillectomy. Methods: The present paper was a double-blind controlled clinical trial study. The statistical population consisted of 87 children aged 4-10 years who were candidates for tonsillectomy. All patients in all 3 groups underwent general anesthesia in the same way and the knife surgery method was the same in all patients. 5 minutes before the incision, 2 cc in the first group and 2 cc in the second group in the children in the bed and around the tonsils were injected locally and no intervention was performed in the control group. Pain intensity in children 2, 4, 6 and 8 hours after surgery was assessed using the Wang Baker pain scale. The collected data were analyzed using descriptive and analytical statistical tests (95% confidence interval and significance level (p 0.05). There was a statistically significant difference between the pain intensity range of children in the two intervention groups and children in the control group at all measurement times (2, 4, 6 and 8 hours after surgery) (p=0.001). Conclusion: Topical injection of bupivacaine and lidocaine-epinephrine combination around the tonsils reduced the severity of pain in children after tonsillectomy, however no difference was seen in the effect of topical bupivacaine injection with lidocaine-epinephrine combination on postoperative pain relief after surgery not observed except at 2 and 4 hours after surgery. Topical injection of bupivacaine and lidocaine-epinephrine combination was safe at the injected concentration and no side effects were observed.
