The Effect of Pre-Incisional Infiltration of Tonsils with Bupivacaine on the Pain Following Tonsillectomy Under General Anesthesia

Does topical lidocaine with adrenaline have an effect on morbidity in pediatric tonsillectomy?

“…In Wong's study [20], peritonsiller infiltration of bupivacaine 0.5% with 1:200,000 epinephrine provided better post-tonsillectomy pain control in the immediate post-operative period than bupivacaine spray or placebo. Jebeles et al [21] showed a notable reduction of pain after tonsillectomy in children aged 6-18 years when the tonsillar fossae were preoperatively infiltrated with bupivacaine. Also, in Somdas's study, post-operative local bupivacaine infiltration in tonsillectomy patients was found effective in children [22].…”

Modified infiltration technique in tonsillectomy: expanded case report of 25 children

“…Few studies indicated that post-tonsillectomy pain management could be improved with infiltration of peritonsillar area [2,9,11,17,18,24]. Other studies showed no significant difference [13,14].…”

“…Support for a preemptive analgesic action of local anesthetic mixture has been reported after tonsillectomy in children [2,9,11,17]. This preemptive effect could have resulted by decreasing the peripheral nociceptive stimulus that decreases the expansion of peripheral hypersensitivity and hyperalgesia, and could also resulted by suppression of the central nervous system excitability before the nociceptive input is received and acute pain behavior may be diminished or abolished with local anesthetics [2,11,17,18].…”

“…Several studies underscored the need for an adjustable technique of infiltration with a minimal volume of mixture anesthetic to improve the posttonsillectomy pain based on a histo-anatomical approach [7,9,11].…”

Präemptive Analgesie mit Ropivacain bei Tonsillektomien im Erwachsenenalter

“…Jebeles et al fanden in ihrer Untersuchung, daß vor der Inzision durchgeführte Infiltrationen mit Bupivacain in die Tonsillenloge verglichen mit Plazebo den postoperativen Schmerzscore sowohl in Ruhe als auch beim Schlucken signifikant senkte [10]. Orntoft und andere Untersucher konnten hingegen keinen präemptiven analgetischen Effekt von Lokalanästhetika nachweisen [3, 22,27].…”