Ropivacaine Peritonsillar Infiltration for Analgesia after Adenotonsillectomy in Children: A Randomized, Double-Blind, Placebo-Controlled Study

Abstract

Peritonsillar infiltration with 0.75% ropivacaine does not provide any major postoperative analgesic effect in 3- to 7-year-old children after adenotonsillectomy. A possible clinically minor analgesia 6 hours after surgery is suggested.

Do diet and activity restrictions influence recovery after adenoidectomy and partial tonsillectomy?

“…Fever and nausea rates and pain peak intensity and mean duration did not differ between the discussed groups of children, however frequency of indications for antibiotic treatment was highest in the group subjected to hard food. Pain intensity is always a subjective measure but in children it is even more difficult to objectify [23]. Conforming to the literature, a relatively low level of pain was found in the majority of the participants of this study [24].…”

Preemptive Submucosal Infiltration with Ropivacaine for Uvulopalatopharyngoplasty

“…Higher concentrations of ropivacaine, such as 2%, have been reported to be effective against both early and late postoperative pain, especially when swallowing after tonsillectomy in adults. 18 In this study, we preemptively administered 0.33% ropivacaine, which is a lower concentration than that reported in the literature. We suggest that effective postoperative pain relief with fewer side effects, such as swallowing difficulty and CNS and cardiovascular toxicity, may be sustained at lower doses of ropivacaine.…”

“…Studies in volunteers and patients suggest that ropivacaine is similar to bupivacaine in onset, duration, and extent of sensory block, although the motor block is less intense and of shorter duration. [18][19][20][21] Recent studies of local infiltration with ropivacaine have obtained promising results, showing a series of advantages. 4,19,22 In particular, compared to bupivacaine, which produces peripheral vasodilation, ropivacaine produces vasoconstriction and has only mild CNS and cardiovascular system toxicity in humans.…”

Rectal acetaminophen versus peritonsillar infiltration of bupivacaine for postoperative analgesia after adenotonsillectomy in children

“…Although peritonsillar infiltration of different drugs for postoperative analgesia in children undergoing adenotonsillectomy has been mentioned before [4][5][6][7][8][9][10][11][12][13], there are a number of considerations regarding local bupivacaine effects. First of all, some studies have claimed the possibility of lack of analgesic effects attributable to bupivacaine [15].…”

“…Peritonsillar infiltration of different types of drugs in children undergoing adenotonsillectomy has been cited many times during the past years, using local anesthetics [4], opioids [5,6], corticosteroids [7][8][9], ketamine [10,11], gabapentine [12] and even non-pharmacologic interventions [13] as adjuvant local analgesic compounds.…”