Effect on Post-Tonsillectomy Pain after Peri-Tonsillar Infiltration of 0.75% Ropivacaine: A Prospective Study

Abstract

Background and objectives: To study the efficacy of peri-tonsillar infiltration of 0.75%ropivacaine with adrenaline in the management of post-tonsillectomy pain. Materials and methods: This prospective study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery, Adichunchanagiri Institute of Medical Sciences, B.G. Nagara, Mandya district. The study period was from November 2017 to July 2019. A sample size of 30 patients which satisfied the inclusion criteria was included in the study. Ropivacaine (0.75%) with Adrenaline (1:200000) was locally infiltrated on the right side (R-side) in the peri-tonsillar region before the surgery and in the tonsillar fossa after the surgery. The left side was considered as the control side. Patients were followed up on 1st and 7th post-operative days for the measurement of post-operative pain. For the assessment of post-operative pain, Visual Analogue Scale was used (VAS). Results: 17(56.7%) females and 13(43.3%) males participated in the study. Majority of the cases belonged to <10 years of age group. On 1st post-operative day, pain on the right side was significantly lower compared to the left side (p value <0.0001), however the reduction of pain scores on right side compared with that of the left side was not significant (p value=0.536) on the 7th post-operative day. Interpretation and conclusion: The peri-tonsillar infiltration of ropivacaine(0.75%) with adrenaline (1:200000) is effective and significant in reducing post-operative pain on the 1st post-operative day, but not so significant on the 7th post-operative day .Hence we recommend the use of peri-tonsillar infiltration of ropivacaine (0.75%) with adrenaline in view of better management of post-operative pain.