Inclusion of pethidine in lidocaine for infiltration improves analgesia following tonsillectomy in children

Elhakim, M.; Salam, A. Y. Abdul; Eid, A.; Kaschef, Nevine A; Mostafa, Badr Eldin

doi:10.1111/j.1399-6576.1997.tb04668.x

Cited by 22 publications

(13 citation statements)

References 16 publications

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“…A previous study by Elhakim et al [7] demonstrated that administration of lidocaine combined with pethidine to the peritonsillar fossa pre-operatively could provide considerable postoperative pain relief in infants and children. We hypothesised that the inclusion of pethidine and bupivacaine would offer more reliable pain relief, at least in the early postoperative period, because of the more prolonged local anaesthetic effect of bupivacaine.…”

Section: Discussionmentioning

confidence: 99%

“…In the study of Elhakim et al [7] electrodissection rather than snare dissection was used for tonsillectomy. The introduction of an electrodissection surgical technique has virtually eliminated immediate postoperative haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…It produces a sensory spinal anaesthesia that is roughly equipotent with hyperbaric lidocaine, suggesting it as a local anaesthetic [6]. Elhakim et al showed that administration of a low dose of pethidine in a lidocaine solution for local infiltration during tonsillectomy relieves pain after tonsillectomy in children [7]. Bupivacaine, with a half-life of 4-7 h, would have a longer duration of action in comparison with shorter acting anaesthetics such as lidocaine, reducing the need for administration of postoperative pain medication.…”

mentioning

confidence: 99%

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Peritonsillar infiltration with bupivacaine and pethidine for relief of post‐tonsillectomy pain: a randomised double‐blind study

et al. 2007

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SummaryPrevious studies of infiltration of local anaesthetics in children undergoing tonsillectomy resulted in conflicting results. The aim of this study was to evaluate the effect of the peritonsillar injection of bupivacaine and pethidine on postoperative pain in children undergoing snare-dissection tonsillectomy. In a double-blind study, 80 children (aged 7-15 years) were randomly divided into two groups receiving peritonsillar injection of either bupivacaine (1 mg.kg ) in adrenaline 1 : 200 000 (treatment group) or an equivalent volume of saline (placebo group) pre-operatively. The time needed for first demand of analgesia and analgesic consumption to reduce the visual analogue scale (VAS) for resting throat pain to £ 30, the VAS for pain on swallowing, drinking liquid and eating a soft diet, incidence of nausea and vomiting, and the need for rescue anti-emetics in the first 24 h after operation were compared in both groups. The combination of bupivacaine and pethidine could significantly decrease the consumption of analgesics for resting pain at 4,6,8,12, and 24 h after operation but did not reduce pain on swallowing, drinking liquid and eating a soft diet. The times to demand of first dose of analgesic and to first oral intake were not significantly different. The overall satisfaction of patients in relation to relief of postoperative pain was not significantly different between the two groups. Although peritonsillar injection of pethidine and bupivacaine in children reduces the analgesic consumption, it does not affect the dynamic pain state in the first 24 h after snare-dissection tonsillectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Peritonsillar infiltration with bupivacaine and pethidine for relief of post‐tonsillectomy pain: a randomised double‐blind study

et al. 2007

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“…Combined assessment by child, nurse, and parents as applied in our study may be a valid means of improving the validity of pain scoring in children. 22 The long-term administration of corticosteroids is associated with adverse events, such as increased risk of infection, delayed wound healing, glucose intolerance, adrenal suppression, and a vascular necrosis of the hip or other joints. Although a single dose of dexamethasone is considered safe, further studies with longer follow-ups are indicated.…”

Section: Figure 1 Median Children's Hospital Eastern Ontario Painmentioning

confidence: 99%

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Elhakim

Rashed

et al. 2003

Can J Anesth/J Can Anesth

148

121

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P Pu ur rp po os se e: : Previous studies on dexamethasone's antiemetic and analgesic potential in children undergoing tonsillectomy have produced conflicting results. The aim of this study was to evaluate the effects of a single dose of dexamethasone on the incidence and severity of postoperative vomiting and pain in children undergoing electrocautery tonsillectomy under standardized general anesthesia. M Me et th ho od ds s: :In a double-blinded study, 120 patients were randomly allocated to receive either dexamethasone 0.5 mg·kg -1 (maximum dose 8 mg) iv or an equivalent volume of saline preoperatively. The incidence of early and late vomiting, need for rescue antiemetics, time to first oral intake, time to first demand of analgesia and analgesic consumption were compared in both groups. Pain scores used included Children's Hospital Eastern Ontario Pain Scale, "faces", and a 0-10 visual analogue pain scale.R Re es su ul lt ts s: : Compared with placebo, dexamethasone significantly decreased the incidence of early and late vomiting (P < 0.05, P < 0.001 respectively). Fewer patients in the dexamethasone group needed antiemetic rescue (P < 0.01). The time to first oral intake was shorter, and the time to first dose of analgesic was longer in the dexamethasone group (P < 0.01). Pain scores 30 min after extubation were lower (P < 0.05) in the dexamethasone group. At 12 and 24 hr postoperative swallowing was still significantly less painful in the dexamethasone group than in the control group (P < 0.01).C Co on nc cl lu us si io on n: : Preoperative dexamethasone 0.5 mg·kg -1 iv reduced both postoperative vomiting and pain in children after electrocautery tonsillectomy. ONSILLECTOMY is one of the most frequently performed ambulatory surgical procedures in children and is associated with an incidence of postoperative vomiting ranging between 40% and 73%. 1-3 The introduction of an electrodissection surgical technique has virtually eliminated immediate postoperative hemorrhage. However, it may cause more pain, discomfort Résultats : Comparée au placebo, la dexaméthasone a significativement réduit l'incidence de vomissements précoces et tardifs (P < 0,05, P < 0,001 respectivement). Peu de patients ayant reçu la dexaméthasone ont eu besoin d'antiémétique de secours (P < 0,01

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“…In our study we used 4 mg/kg dose of 10% lignocaine aerosol in tonsillar fossa in both study group B and C and no lignocaine toxicity noted in any patient. In their study, 19,20 they successfully used 10% lignocaine spray which administered topically in tonsillar bed to alleviate immediate post-operative pain and discomfort in tonsillectomy patients.…”

Section: Discussionmentioning

confidence: 99%

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

Dalwadi¹,

Dalwadi²

2015

Int J Res Med Sci

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INTRODUCTIONPain is an unpleasant sensory and emotional experience dut to tissue damage. Post-operative pain relief is an important and inevitable part of anaesthesia. In past postoperative pain relief was neglected in paediatric patients because of misconceptions as children don't feel much pain and don't remember as adults.It is proven that significant psychological trauma and sufferings with fear and apprehension can occur in children due to surgical pain. Painful and distressed recovery would cause a great impact on child psyche and delay the early discharge.As tonsillectomy is most commonly carried out in children it is many a time first surgical exposure for otherwise healthy child. Pain relief post-tonsillectomy in children remains a dilemma for anaesthetists. Rapid ABSTRACT 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.

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Inclusion of pethidine in lidocaine for infiltration improves analgesia following tonsillectomy in children

Abstract: Inclusion of a low dose of pethidine in lidocaine for tonsillar infiltration improves pain relief after tonsillectomy in children.

Cited by 22 publications

References 16 publications

Peritonsillar infiltration with bupivacaine and pethidine for relief of post‐tonsillectomy pain: a randomised double‐blind study

Peritonsillar infiltration with bupivacaine and pethidine for relief of post‐tonsillectomy pain: a randomised double‐blind study

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

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

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