Efficacy of bupivacaine infiltration for controlling post‑tonsillectomy pain, duration of surgery and post‑operative morbidities: A systematic review and meta‑analysis

Wang, Juan; Wang, Ning; Gong, Fanghua

doi:10.3892/etm.2021.9631

Cited by 6 publications

(6 citation statements)

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“…As it is not a perfect treatment alone, according to a previous study, postoperative vessel embolization [10] and intraoperative bupivacaine injection [11] are possible measures to reduce postoperative bleeding and pain. Thorough preoperative planning and consideration of those measures are necessary to minimize postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

The underrated role of cold drinks in post-tonsillectomy care: a pediatric case study

Kang,

Kim

2024

Oral Biol Res

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The benefits of traditional techniques like cold dissection, hot methods, and suturing for reducing post-tonsillectomy complications such as swelling, pain, and bleeding have been established, however, the postoperative advantages of consuming cold drinks remain underappreciated. This case study aims to highlight the beneficial effects of cold-water consumption in post-tonsillectomy care. An 11-year-old girl suffering from mild rhinitis and severe chronic mouth breathing underwent tonsillectomy. Her postoperative care regimen involved standard instructions coupled with daily intake of cold beverages. This approach resulted in the complete healing of the intraoral wound, without necessitating additional painkillers. Histopathological evaluation revealed right tonsillar hyperplasia laden with bacterial colonies and hyperplasia in the left tonsil. The consumption of cold beverages or ice cream post-tonsillectomy is a promising alternative for postoperative care in pediatric patients. It prompts an organized spontaneous healing process at the wound site and helps pain management.

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Section: Discussionmentioning

confidence: 99%

The underrated role of cold drinks in post-tonsillectomy care: a pediatric case study

Kang,

Kim

2024

Oral Biol Res

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“…Tonsillectomy is a common surgical procedure required to prevent recurrent infection, inflammation and related distress to the patients 1,2 . Tonsillectomy includes complete removal of palatine tonsils.…”

Section: Introductionmentioning

confidence: 99%

“…Bupivacaine inhibits voltage gated sodium channels, block the afferent nerve endings and reduces the intensity of post tonsillectomy pain. Bupivacaine also act as anti-inflammatory agent by inhibiting N methyl D aspartate receptors, inhibiting signaling of Ca 2+ ion, interleukin-1β release in astrocytes and by interacting with 5-hydroxytryptamine, opioid and glutamate receptors 1 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Bupivacaine Infiltration in Post Tonsillectomy Pain Relief

Kousar¹,

Durrani²,

Aziz³

et al. 2021

PJMHS

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Background: Tonsillectomy is a common surgical procedure required to prevent recurrent infection, inflammation and related distress to the patients. Intervention in this highly vascularized area results in inflammatory responses and subsequent pain. Due to inadequate management 30-70% patients suffer from post-operative pain. Post tonsillectomy pain has its impact on analgesic consumption, hospital stay and return to normal activity. Methodology: This randomized control trial study design is a prospective randomized controlled including convenience sample of 32 patients of both genders, aged 4-30 years undergoing tonsillectomy.Tonsillectomy was performed by standard dissection method after giving general anesthesia to the patients. After completing the tonsillectomy on right side, surgeon infiltrated 6ml of 0.25 % bupivacaine in the tonsillar fossa on the right side. The surgeon did not infiltrate into the left side being observed as control. Postoperative pain score was recorded by asking patients on a VAS graded 1-10 scale (0= no pain and 10= maximum pain) after half an hour in recovery, 2 hours, 4 hours and 6 hours after the operation. Results: The mean age of the study patients was 14.08±7.32 years which included 20 (62.5%) females and 12(37.5%) males. The mean of duration of operation was 42.03±14.75 minutes. There was statistically significant difference between pain scores on VAS in infiltrated bupivacaine (right side) and control (left side) after ½, 2,4 and 6 hours respectively. Conclusion: Infiltration of 0.25% bupivacaine significantly reduces post tonsillectomy pain. Keywords: Tonsillectomy, Bupivacaine infiltration, Pain

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“…5 However, reducing postoperative pain and subsequent narcotic use remains a hot-button topic. 6,7 To better understand the effects of local anesthetic injection on pediatric tonsillectomy, a systematic review and metaanalysis was performed. The objective of this study was to assess the effect of local anesthetic injection as compared with saline injection on subjective pain scores for pediatric tonsillectomies on postoperative days (PODs) 0 and 1.…”

mentioning

confidence: 99%

“…Additional studies have focused on the timing of injection—specifically, whether an injection prior to or immediately following tonsillectomy has a larger impact on postoperative pain 5 . However, reducing postoperative pain and subsequent narcotic use remains a hot‐button topic 6,7 …”

mentioning

confidence: 99%

Effect of Local Anesthetic Injections on Subjective Pain Scales in Pediatric Tonsillectomies: A Meta‐analysis

Ortega

Brigger

Nation

2022

Otolaryngol.--head neck surg.

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Objective To assess the effect of local anesthetic injection on subjective pain scores for pediatric tonsillectomies on postoperative days (PODs) 0 and 1. Data Sources A comprehensive literature search was conducted with the PubMed, Embase, Web of Science, and Scopus databases. Review Methods A 2-researcher team following the PRISMA guidelines performed a systematic review and meta-analysis. Studies with original data and a saline injection control arm were selected. Corresponding authors were contacted for missing data. The collated data were analyzed with RevMan version 5.4 (Review Manager; Cochrane Collaboration). Random effects modeling and standard mean difference were utilized to control for heterogeneity. Surgical technique subgroup analysis was performed. Results A total of 319 publications were identified, and 8 articles with 13 experimental arms (627 participants) were selected for meta-analysis. Local anesthetic injection was compared with placebo with saline injection. The standard mean difference for POD 0 pain was −0.81 (95% CI, −1.16 to −0.46; P < .00001) in favor of local anesthetic. The standard mean difference for POD 1 was −1.13 (95% CI, −1.48 to −0.78; P < .00001) in favor of local anesthetic. Subgroup analysis by surgical technique showed a less robust effect for cautery excision (−1.01 [95% CI, −1.37 to −0.66]) vs cold excisional technique (−1.19 [95% CI, −1.64 to −0.74]), with or without cautery-based hemostasis. Conclusions A local anesthetic injection during a pediatric tonsillectomy reduces postoperative pain on POD 0 and 1. Further analysis on total narcotic use and postoperative complications would benefit surgeon decision making.

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Efficacy of bupivacaine infiltration for controlling post‑tonsillectomy pain, duration of surgery and post‑operative morbidities: A systematic review and meta‑analysis

Cited by 6 publications

References 62 publications

The underrated role of cold drinks in post-tonsillectomy care: a pediatric case study

The underrated role of cold drinks in post-tonsillectomy care: a pediatric case study

Efficacy of Bupivacaine Infiltration in Post Tonsillectomy Pain Relief

Effect of Local Anesthetic Injections on Subjective Pain Scales in Pediatric Tonsillectomies: A Meta‐analysis

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