Perioperative local anaesthesia for reducing pain following tonsillectomy

Hollis, Lance; Burton, Martin J; Millar, J.M.

doi:10.1002/14651858.cd001874

Cited by 82 publications

(83 citation statements)

References 26 publications

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“…A variety of methods have been attempted to reduce posttonsillectomy pain, including various surgical techniques, newly developed devices producing low heat and temperature, local or systemic steroid administration, local anesthetic blocks, and use of analgesics [9][10][11][12][13]. Generally, surgical techniques and devices influence postoperative pain more than pharmacologic intervention.…”

Section: Discussionmentioning

confidence: 99%

Effect of cold-water cooling of tonsillar fossa and pharyngeal mucosa on post-tonsillectomy pain

Shin

Byun

Baek

et al. 2014

American Journal of Otolaryngology

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Section: Discussionmentioning

confidence: 99%

Effect of cold-water cooling of tonsillar fossa and pharyngeal mucosa on post-tonsillectomy pain

Shin

Byun

Baek

et al. 2014

American Journal of Otolaryngology

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“…Published data regarding the analgesic effect of local anaesthetic infiltration into the peritonsillar tissue is equivocal and several studies showed that if there is any role, it is limited to the immediate postoperative period [8][9][10][11][12][13]. Hollis et al [14] reviewing six randomised controlled trials, concluded that there is no evidence that the use of peri-operative local anaesthetic in patients undergoing tonsillectomy improves postoperative pain control.…”

Section: Discussionmentioning

confidence: 99%

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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“…Those that did employ local anesthesia often chose different medications with unique pharmacokinetics, and gave different doses either before or after excision. The role of local anesthesia remains unclear, as demonstrated by a 2000 Cochrane Database Review [61] . The authors, however, remained hesitant to make formal recommendations, because the studies reviewed were of small size and pain outcomes were measured differently.…”

Section: Discussionmentioning

confidence: 99%

Tonsillectomy Techniques and Pain: A Review of Randomized Controlled Trials and Call for Standardization

Ashbach

Ostrower

Parikh³

2007

ORL

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Objectives: To review the literature comparing operative techniques in tonsillectomy and postoperative pain. Methods: Randomized controlled trials comparing operative techniques and pain outcomes over a 10-year period were reviewed. Results: 44 trials met inclusion criteria for analysis. A total of nine different techniques for complete or partial tonsillectomy were compared. There were several studies with contradictory results. Many of the studies were performed under different parameters. Conclusions: Future studies comparing tonsillectomy technique and pain outcomes should be conducted using a standard protocol to allow for accurate comparisons between numerous techniques.

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Perioperative local anaesthesia for reducing pain following tonsillectomy

Abstract: Pande YN. Double-blind controlled trial of a throat spray containing benzocaine and cetalkonium chloride on postoperative adult tonsillectomy patients.

Cited by 82 publications

References 26 publications

Effect of cold-water cooling of tonsillar fossa and pharyngeal mucosa on post-tonsillectomy pain

Effect of cold-water cooling of tonsillar fossa and pharyngeal mucosa on post-tonsillectomy pain

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

Tonsillectomy Techniques and Pain: A Review of Randomized Controlled Trials and Call for Standardization

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