Comparison of Topical Bupivacaine, Peritonsillar Dexamethasone Infiltration or Topical Bupivacaine Plus Intravenous Dexamethasone for Post-Adenotonsillectomy Pain Control

Mansour, Abd Elmohsen Elsheikh; Elsayed, Khalid Mohamed; Douma, Abdulghni Othman Abdulghni; Helmy, Khalid Mostafa

doi:10.21608/ejhm.2023.291347

Comparison of Topical Bupivacaine, Peritonsillar Dexamethasone Infiltration or Topical Bupivacaine Plus Intravenous Dexamethasone for Post-Adenotonsillectomy Pain Control

Document Type : Original Article

Authors

10.21608/ejhm.2023.291347

Abstract

Background: About all patients who have had tonsillectomies report experiencing post-operative pain, which often lasts for about a week. Opioids still play a part in post-tonsillectomy pain management despite the absence of codeine, as some children may not have enough pain relief from acetaminophen and ibuprofen alone. Dexamethasone treatment following adult tonsillectomy is the subject of multiple randomized controlled trials.
Objective: The aim of the current study was to evaluate controlling post adenotonsillectomy pain with topical bupivacaine, peritonsillar dexamethasone infiltration or topical bupivacaine plus intravenous dexamethasone.
Patients and methods: A randomized controlled clinical trial was conducted at Zagazig University Hospitals. The study duration was 6 months. Patients were randomly allocated to three equal groups; Group B (topical bupivacaine), Group D (dexamethasone infiltration) and Group BD (topical bupivacaine plus intravenous dexamethasone).
Results: For changes in Multidimensional Assessment of Pain (MAP) scale, like FLACC, initial request for analgesia, first oral intake, and overall quantity of analgesia in the five hours before to discharge, there was a statistically significant difference between the study groups. Demographic information, the length of the surgery, the duration of the anesthesia, and variations in SPO2 did not statistically differ across the study groups. Conclusion: Topical bupivacaine plus intravenous dexamethasone is more effective for controlling post-operative adenotonsillectomy pain than topical bupivacaine or peritonsillar dexamethasone infiltration.

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