Comparison of post-tonsillectomy pain by using tramadol, lignocaine with adrenaline and normal saline swab in tonsillar fossae.

Abstract

Objective: To compare the effects of pain by using tramadol, lignocaine 2% with adrenaline and normal saline (placebo) after tonsillectomy. Study Design: Randomized Controls Trial. Setting: Department of ENT, Social Security Landhi Hospital Karachi. Period: March 2019 to October 2019. Sampling Technique: Non probability. Material & Methods: One hundred and twenty (120) patients with ASA-I status, age between 12 to 22 years were included randomly for this study. Divided the patients into three groups, group-1(L), group-2(T) and group-3(S) and forty (40) patients were in each group. In group-1(L), Lignocaine 2% with adrenaline used. In group-2 (T), Tramadol used and in group-3 (S), normal saline swab (placebo) used in tonsillar fossae at the end of tonsillectomies. Pain assessment done after 30 minutes in PACU and every one hourly for 6 hours post operatively in ward. If recorded VAS for pain was more than 5 analgesic injection given in ward for pain control. Result: The result of our research revealed that there were no significant differences in the mean ages of the patients, weight of patients, sex distribution and the duration of surgeries among the all three groups. Post-operative pain score were significantly higher in (S) group than in the other two groups (p<0.05). In Group-1(L) and Group-2 (T) pain score had non-significant (p>0.05). Duration of first analgesic demand was longer in Group-L and in Group-T versus normal saline (Group-S), it was 134 + 18 minutes in Group-L and in Group -T, it was 135 + 15 minutes while in Group-S, it was 34 + 11 minutes and p < 0.01 significant. Conclusion: Uses of lignocaine 2% with adrenaline swab and Tramadol swab are better choice in tonsillar fossae at the end of tonsillectomies for post-operative pain control versus normal saline (placebo) swab.