Peripheral facial nerve paralysis after peritonsillar infiltration of bupivacaine: a case report

Shlizerman, Lev; Ashkenazi, Dror

doi:10.1016/j.amjoto.2005.02.019

Cited by 32 publications

(13 citation statements)

References 15 publications

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“…24 Injection has also been reported to cause severe upper airway obstruction, 25 facial nerve paralysis, 26 and vocal fold paralysis. 27 However, we did not encounter any complications related to infiltration.…”

Section: Discussionmentioning

confidence: 99%

Effects of Levobupivacaine versus Bupivacaine Infiltration on Postoperative Analgesia in Pediatric Tonsillectomy Patients: A Randomized, Double-Blind, Placebo-Controlled Study

Özmen¹,

Özmen²,

Kasapoğlu³

2011

Ann Otol Rhinol Laryngol

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Objectives:We compared the effects of levobupivacaine hydrochloride, bupivacaine hydrochloride, and saline injections in alleviating posttonsillectomy pain. Methods:Between November 2009 and April 2010, we recruited 60 patients (36 male and 24 female) between 2 and 12 years of age into the study. After informed consent was obtained from the parents, patients admitted for tonsillectomy were randomized into 3 groups by means of sealed envelopes. Group 1 (20 patients; mean age, 6.45 ± 2.78 years) received 0.9% sodium chloride (saline solution), group 2 (20 patients; mean age, 5.60 ± 2.70 years) received 0.25% levobupivacaine hydrochloride, and group 3 (20 patients; mean age, 5.85 ± 2.43 years) received 0.5% bupivacaine hydrochloride infiltrated around each tonsil. Pain was evaluated with McGrath's face scale. Results:The postoperative pain scores at 1 and 5 hours were similar among the groups (p > 0.05). The pain scores in the levobupivacaine group were lower than those in the saline group at 13 hours (p < 0.017). The pain scores in the bupivacaine and levobupivacaine groups were significantly lower than those in the saline group from 17 to 21 hours until day 6 (p > 0.017). There was no difference between the levobupivacaine and bupivacaine groups (p > 0.017). Conclusions:Local infiltration of levobupivacaine is a relatively safe and effective method and is equivalent to use of bupivacaine for posttonsillectomy pain.

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Section: Discussionmentioning

confidence: 99%

Effects of Levobupivacaine versus Bupivacaine Infiltration on Postoperative Analgesia in Pediatric Tonsillectomy Patients: A Randomized, Double-Blind, Placebo-Controlled Study

Özmen¹,

Özmen²,

Kasapoğlu³

2011

Ann Otol Rhinol Laryngol

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“…The reported complications due to the injections into tonsillar and adenoid beds, especially after the deep and large volume infiltrations of local anesthetics with vasoconstrictors, are; vocal cord paralysis, taste disturbance, severe upper airway obstruction with pulmonary edema, deep cervical abscess, brain stem stroke, osteomyelitis, horner syndrome and peripheral facial nerve paralysis [26,[33][34][35][36][37][38][39][40]. The side effects peculiar to the injected medication can also be seen.…”

Section: Discussionmentioning

confidence: 94%

Does preincisional injection of levobupivacaine with epinephrine have any benefits for children undergoing tonsillectomy? An intraindividual evaluation

Taş

Hancı

Uğur

et al. 2010

International Journal of Pediatric Otorhinolaryngology

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“…First of all, some studies have claimed the possibility of lack of analgesic effects attributable to bupivacaine [15]. On the other hand, a number of studies have reported the clinical complications seen following local bupivacaine administration, especially when bupivacaine is administered deeply, in large drug volumes, and into the soft tissue beds of the tonsils and adenoids [16,17]; among these complications, one may consider bilateral paralysis of the vocal cords, deep cervical abscess which maybe even life threatening and finally, stroke in the brain stem area which accompanies intra-operative cardiac asystole after unintentional intraarterial entrance of bupivacaine [16,17]. This study demonstrates this method to be an appropriate alternative and suggests rectal acetaminophen with the same analgesic effects of the peritonsillar bupivacaine infiltration.…”

Section: Discussionmentioning

confidence: 98%

Rectal acetaminophen versus peritonsillar infiltration of bupivacaine for postoperative analgesia after adenotonsillectomy in children

Dahi-Taleghani

Mousavifard

Tahmoureszade

et al. 2010

Eur Arch Otorhinolaryngol

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There are a wide range of analgesic methods used for postoperative pain control in children undergoing elective adenotonsillectomy and there are many cases in which the postoperative analgesic modalities have not been fully successful to treat pain effectively. The acute postoperative analgesic effects of peritonsillar bupivacaine infiltration compared with rectal acetaminophen suppositories in elective adenotonsillectomy have been compared here. The methods employed were a single blind randomized clinical trail where 110 cases were selected to enter the study. After induction of anesthesia and intubation, and just before start of the procedure, the 1st group received 30 mg/kg of acetaminophen rectally; while, the 2nd group received 1 mg/kg peritonsillar bupivacaine infiltration around the tonsils. Throat pain at rest, after swallowing, after taking fluid and after soft food and also, parents' and nurses satisfaction regarding patient analgesia were compared. The results stated that there was no difference between the two groups regarding throat pain at rest, after swallowing, after taking fluid and after soft food and also, parents' and nurses' satisfaction. We concluded that when considering the feasibility of rectal acetaminophen, the results of the study suggest it superior due to minimal risks compared with local peritonsillar administration of bupivacaine for elective adenotonsillectomy of children.

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Peripheral facial nerve paralysis after peritonsillar infiltration of bupivacaine: a case report

Cited by 32 publications

References 15 publications

Effects of Levobupivacaine versus Bupivacaine Infiltration on Postoperative Analgesia in Pediatric Tonsillectomy Patients: A Randomized, Double-Blind, Placebo-Controlled Study

Effects of Levobupivacaine versus Bupivacaine Infiltration on Postoperative Analgesia in Pediatric Tonsillectomy Patients: A Randomized, Double-Blind, Placebo-Controlled Study

Does preincisional injection of levobupivacaine with epinephrine have any benefits for children undergoing tonsillectomy? An intraindividual evaluation

Rectal acetaminophen versus peritonsillar infiltration of bupivacaine for postoperative analgesia after adenotonsillectomy in children

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