The Effect of Lesser Palatine Nerve Block on Pain after Elective Pediatric Tonsillectomy

Abstract

Background: This prospective double-blind randomized study was performed to evaluate the an- algesic effect of lesser palatine nerve block for postoperative pain control after a pediatric tonsillectomy and to compare the analgesic effects of pre-emptive versus postoperative blocks. Methods: Forty-eight ASA class 1 children scheduled for an elective tonsillectomy were randomized into three groups. Patients received lesser palatine nerve blocks using divided doses of 0.05 ml/kg of 0.2% ropivacaine 5 min prior to the beginning of tonsillectomy (Pre-block group or immediately after surgery (Post-block group. Patients allocated into the Control group did not receive any nerve block. Postoperative pain was measured immediately after surgery 3 6 12 and 24 hours following operation using a 0 to 4 points pain scale based on a facial expression of pain scale ruler. Side effects and the number of analgesic injections were observed for 24 hours postoperatively. Results: No significant differences in the pain scores were observed immediately after surgery and at 3 6 12 and 24 hours after operation in the three groups (P > 0.05. The number of analgesic injections was similar in the groups. Conclusions: T he results of this study reveal that the lesser palatine ner ve block was not effective for postoperative pain control following pediatric tonsillectomy and that the pre-emptive block offered no pain control benefit over the postoperative block. Therefore we do not recommend lesser palatine nerve blocks for the management of postoperative pain after pediatric tonsillectomy. (Korean J An- esthesiol 2003; 44: 820~827