Abstract
Objective: Tonsillectomy is one of the most frequent operations performed worldwide. Pain and hemorrhage are the most complications. Reduction in post-operative pain prevents the dehydration from reduced oral intake. Peritonsillar infiltration of epinephrine with bupivacaine might have some role for this purpose.
Method: 72 children who were candidates for adenotonsillectomy randomly were divided into three groups including: patients who injected by normal saline preoperation (placebo group); those injected by bupivacaine and epinephrine preoperation (group 2); and postoperation (group 3). Postoperative pain, hemorrhage and the time of oral intake were measured.
Results: Only VAS pain score in 30 minutes post-operation was significantly different between placebo and the group 2 (p=0.02). Swallowing pain in 6 hours after tonsillectomy was decreased in drug injection groups compared with placebo group (p< 0.05). The first time of oral intake was not different among groups, statistically. Immediate post-tonsillectomy hemorrhage was significantly higher in placebo group compare to the other groups while delay hemorrhage did not show any difference.
Conclusion: Peritonsillar injection of epinephrine with bupivacaine before or after tonsillectomy will reduce immediate post-operative hemorrhage and lead to reduction in the swallowing pain . Early feeding could be a factor for prevention of unwanted outcomes such as fever and secondary dehydration.
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