Comparison of analgesic effect of peritonsillar infiltration with bupivacaine versus bupivacaine-dexamethasone in children undergoing tonsillectomy.

Abstract

Objective: To compare analgesic effect of peritonsillar infiltration with bupivacaine versus bupivacaine-dexamethasone in children undergoing tonsillectomy. Study Design: Randomized Control study. Setting: Aziz Fatimah Hospital, Faisalabad. Period: 01-03-2018 to 31-12-2018. Material & Methods: 80 patients were enrolled in the clinical study using non-probability consecutive sampling technique. They were divided into two groups, before start of surgery group BD received peritonsillar infiltration of bupivacaine and dexamethasone combination, whereas group B received local infiltration of bupivacaine only. Primary outcome measures were pain score recorded immediately after recovery of patient (0 hour) and at 2, 6, 12 and 24 hours after surgery and requirement for analgesia postoperatively. Other parameters recorded were time to first oral intake and sleep pattern over 24 hours. Results: Mean pain scores in group BD were 0.075, 0.225, 1.675, 0.75, 0.275 and in1 group B were 0.65, 0.975, 2.95, 1.5, 0.95 at 0, 2, 6, 12, 24 hours postoperatively respectively. 92.5% patients in group BD and & 57.5% in group B had good sleep whereas 7.5% in group BD and 42.5% in group B had disturbed sleep. 6 patients in BD group and 26 in B group required analgesia. Conclusion: Our study concluded that infiltration of tonsillar fossa with bupivacaine – dexamethasone prior to the start of surgery provides better postoperative analgesia, early start of oral intake, less rescue analgesic requirements and better sleep pattern.