Effect of topical bupivacaine on post-tonsillectomy pain relief in children

Abstract

Tonsillectomy is a common surgery performed in paediatric otorhinolaryngology and is usually accompanied by considerable postoperative pain. Earlier literature has shown the use of topical bupivacaine for post-tonsillectomy pain relief to be promising. This study was conducted to evaluate the efficacy of topical bupivacaine application on post-tonsillectomy pain relief. Fifty consenting patients scheduled for tonsillectomy that met the inclusion criteria were enrolled in the study and assigned into two groups of 25 patients each. Group B had their tonsillar fossa packed with 0.5% bupivacaine soaked gauze for 5 minutes while Group S had normal saline. Pain intensity was measured at 1, 2, 4, 12 and 24 hours postoperatively, using the Faces Pain Scale- Revised (FPS-R). Mean scores for groups B and S at 1, 2, 4, 8, 12, 24 hours were 1.96±1.17, 2.40±0.82, 2.8±1.0, 2.88±1.17, 3.08±0.99, and 3.04±1.02 and 3.36±1.38, 4.72±1.62, 3.92±1.35, 3.76±1.45, 4.00±1.41, 3.38±0.98 respectively. The difference was significant at 1 and 2 hours only (P≤0.05). Post-tonsillectomy pain was reduced in the first two hours by application of bupivacaine soaked gauze.