Propranolol in the Treatment of Subglottic Hemangiomas

Abstract

Postoperative pain after pediatric tonsillectomy. 96 patients aged 2-14 in a tertiary care children hospital in Chihuahua, Mexico. 48 control patients were injected with a 1.5 ml saline injection, and 48 patients injected with a 1.5 ml mixture of lidocaine 2% plus epinephrine 1/200,000, fentanyl 50 mg, clonidine 150 mcg/ml pre incisional. All tonsillectomies were done by the same surgeon, with a monopolar technique, outpatient procedure. Patients' parents were instructed to complete an 8 hour basic evaluation of pain day 0 through day 7 and written down on a leaflet (scale 0-10), with the Wong faces pain scale, diet ingested on each meal from day 0 through day 7. The Mann-Whitney U test was used to determine the statistical significance for samples. Nominal data of groups were compared by using the chi-square or Fischer's exact test. P value of ϭ0.0001 was considered significant. Independent variables: Lingual nerve blockage, nominal scale, qualitative type. RESULTS: Charts of 122 patients were reviewed. 26 were discarded due to incorrect completion. 96 charts were included. Regarding pain was a significant difference in the infiltration group with a 2 points reduction from day 0 through day 4 (pϭ0.0001). Diet was started 24 hours before control group. There was a clinical significance. Parent satisfaction had a better score in the local anesthetic group. CONCLUSION: Pre-incisional infiltration of an anesthetic mixture combined with general anesthesia reduces significantly post-tonsillectomy pain in children and provides a much faster return to normal activity compared to general anesthesia alone or in combination with placebo infiltration. Injection in the tonsillar fossae is a simple and safe method.

Hemangiomas cervicales. Descripción de cuatro casos

“…La tasa de respuesta varía del 80% al 100% según la series publicadas [5,19,20,21]. En casos de hemangiomas subglóticos infantiles también está descrito el tratamiento con propanolol [22].…”