Effect of Local Bupivacaine Infiltration on Post-Tonsillectomy Pain


Department of ENT, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences and Health Services, TEHRAN-IRAN.


Background: Tonsillectomy is still one of the most common surgeries in the world which is accompanied by severe pain post-operatively. Although analgesic drugs are used orally or parenterally to control post-tonsillectomy pain, it is still one of the complications of this procedure especially in adults. Regarding the controversy in the role of injection of local analgesic drugs in tonsillectomy and the high prevalence of this procedure, the present study was performed to evaluate the effect of local bupivacaine infiltration, as an analgesic drug on pain after tonsillectomy in patients older than 9 years of ages. Materials and Methods: A double-blind experimental clinical trial was performed during a 3-year-period of time. One hundred and seven patients over 9 years old who were candidates for tonsillectomy because of recurrent tonsillitis (more than 6 times in a year or more than 3 times for at least two consecutive years), were selected. All patients underwent tonsillectomy by dissection/snare technique, and suturing the bleeding sites. The method of anesthesia was similar in all individuals. For each patient, 5 ml of 0.5% bupivacaine was injected into one tonsil, as the case, and 5 ml of normal saline was injected into the other one, as the control. Neither the surgeon nor the patient was aware of the content of these two injectable materials. The type of material was randomly selected for each tonsil. The intensity of post-tonsillectomy pain at each side was measured 4, 8, and 24 hours and one week post-operatively by numeric pain intensity scale (NPS) in 107 patients. Data were analyzed by SPSS software and paired t-test with 95% confidence interval. Results: This study showed that the difference in the mean level of post-tonsillectomy pain was significant between the case and the control groups regardless of age (p