Effect of pre-incisional infiltration of 0.5% ropivacaine versus placebo in post-operative pain relief among patients undergoing tonsillectomy under general anaesthesia: a comparative study

Authors

  • Sushil Namdeorao Meshram Department of ENT, Tata Main Hospital, Jamshedpur, Jharkhand, India http://orcid.org/0000-0001-9218-6436
  • Ankesha Ghanshyam Walthare GMC Miraj, Miraj, Maharashtra, India
  • Jayant Krishna Sonone GH Khamgoan, Khamgoan, Maharashtra, India
  • Alok Kumar Department of ENT, Tata Main Hospital, Jamshedpur, Jharkhand, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20203564

Keywords:

Ropivacaine, Tonsillectomy, Adenotonsillectomy, BOPS

Abstract

Background:  Pain is the most common complaint in the immediate post-tonsillectomy period. Inadequate post-tonsillectomy pain management has many drawbacks. Ropivacaine is a new long acting local anaesthetic, structurally closely related to bupivacaine.

Methods: It was a prospective double blinded randomized control trial on a total of 50 patients who were posted for tonsillectomy. Randomization of each patient was done into two groups one of which had received 4 ml of 0.5% ropivacaine hydrochloride solution and other 4 ml normal saline. Data entry and analysis was done with (SPSS IBM) version 21.0. Both univariate and bivariate analysis done. Proportions were calculated for qualitative variables and mean with standard deviation was done for quantitative variables. Required tests of significance such as Chi square test and independent test were applied. Significance of p value is taken as p<0.05. Postoperative pain, first post op oral intake, duration of post-operative hospital stay, and postoperative haemorrhage was assessed. The intensity of postoperative pain was assessed on behavioural observational pain Scale and Wong baker faces pain rating scale.

Results: Pre-incisional infiltration of 0.5% Ropivacaine was an effective method to reduce post-operative pain in patients undergoing tonsillectomy under GA. Effect of  Ropivacaine was statistically significant (p<0.05).

Conclusions: We recommend the use of 0.5% ropivacaine pre-incisional infiltration in patients undergoing tonsillectomy.

Author Biographies

Sushil Namdeorao Meshram, Department of ENT, Tata Main Hospital, Jamshedpur, Jharkhand, India

junior resident doctor at department of ENT

Ankesha Ghanshyam Walthare, GMC Miraj, Miraj, Maharashtra, India

Junior Resident, Department of Ophthalmology

Jayant Krishna Sonone, GH Khamgoan, Khamgoan, Maharashtra, India

Specialist Medical Officer, Department of ENT

Alok Kumar, Department of ENT, Tata Main Hospital, Jamshedpur, Jharkhand, India

ENT Specialist

References

Akoglu E, Akkurt BC, Inanoglu K, Okuyucu S, Daglı S. Ropivacaine compared to bupivacaine for post-tonsillectomy pain relief in children: a randomized controlled study. Int J Pediatr Otorhinolaryngol. 2006;70(7):1169-73.

Markham A, Faulds D. Ropivacaine. Drugs. 1996;52(3):429-49.

Knudsen K, Suurküla MB, Blomberg S, Sjövall J, Edvardsson N. Central nervous and cardiovascular effects of iv infusions of ropivacaine, bupivacaine and placebo in volunteers. British J Anaesthesia. 1997;78(5):507-14.

Scott DB, Lee A, Fagan D, Bowler GM, Bloomfield P, Lundh R. Acute toxicity of ropivacaine compared with that of bupivacaine. Anesthesia Analgesia. 1989;69(5):563-9.

Garra G, Singer AJ. The Wong-Baker Pain FACES Scale Measures Pain, Not Fear. Pediatric Emergency Care. 2013;29(1):17-20.

Arikan OK, Ozcan S, Kazkayasi M, Akpinar S, Koc C. Preincisional infiltration of tonsils with ropivacaine in post-tonsillectomy pain relief: double-blind, randomized, placebo-controlled intraindividual study. J Otolaryngol. 2006;35(3):167-72.

Hesselgard K, Larsson S, Romner B, Stromblad LG, Reinstrup P. Validity and reliability of the behavioral observational pain scale for post-operative pain measurement in children 1-7 years of age. Ped Crit Care Med. 2007;8(2):102-8.

Wilson ME, Helgadóttir HL. Patterns of pain and analgesic use in 3to7 year old children after tonsillectomy. Pain Manag Nurs. 2006;7(4):159-66.

Ozkiriş M, Kapusuz Z, Saydam L. Comparison of ropivacaine, bupivacaine and lidocaine in the management of post-tonsillectomy pain. Int J Pediatr Otorhinolaryngol. 2012;76(12):1831-4.

Oghan F, Harputluoglu U, Guclu E, Kocaman B, Ozturk O. Does topical ropivacaine reduce the post-tonsillectomy morbidity in pediatric patients?. Int J Pediatr Otorhinolaryngol. 2008;72(3):361-5.

Downloads

Published

2020-08-25

Issue

Section

Original Research Articles