Effect of Local Injection of Bupivacaine for Pain Management After Tonsillectomy: A Randomized Clinical Trial

Abstract

Background: Pain is one of the main side effects of tonsillectomy, especially in the pediatric population. Objectives: This study aimed to examine the effects of a local injection of bupivacaine on pain and postoperative nausea and vomiting after tonsillectomy. Methods: In this double-blind clinical trial, we enrolled 96 patients who were referred for elective tonsillectomy to the ear, nose, and throat (ENT) Clinic of Imam Khomeini Hospital in Ahvaz, Iran, from December 2016 to January 2018. The patients were selected by the simple random sampling method on a 1:1 ratio. To analyze the data, Student's t‐test or chi‐squared test were used. Results: Visual analog score measured in the recovery period at 0, 1, 2, 4, 8, 12, and 24 h after surgery was significantly lower in the Bupivacaine group than in the Placebo group (P < 0.001). Nausea was significantly different between the groups at all time, but for vomiting, significant differences between the groups were noted at 0, 1, 2, 4, and 8 h but not at 12 and 24 h after surgery. Conclusions: Preoperative local injection of 0.5% bupivacaine for tonsillectomy was effective in reducing postoperative pain, and it significantly reduces postoperative nausea and vomiting in children.

Evaluation of penehyclidine for prevention of post operative nausea and vomitting in patients undergoing total thyroidectomy under total intravenous anaesthesia with propofol-remifentanil

“…The common risk factors include female, nonsmokers, a history of PONV or motion sickness, and the use of opioids [1]. PONV increases the risk of aspiration of gastric contents, suture dehiscence, postoperative bleeding, and airway obstruction by hematoma, which may affect the surgical treatment and postoperative recovery time [2]. The incidence of PONV after thyroid surgery is reported to be 60-80% when no prophylactic antiemetic is administered [3,4].…”