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Role of Intraoperative Topical Application of 0.5% Bupivacaine in Tonsillar Fossa for Postopeartive

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Context: Tonsillectomy is the second most common surgical procedure performed in pediatric patients. Post­Tonsillectomy pain is regarded as a major morbidity in early post­operative period which delays the oral intake & discharge of patients. Topical application of Local Anesthetic like Bupivacaine at the site of trauma reduces post­operative pain resulting in early oral intake & early discharge unlike local infiltration in which complication rate is high for intravascular injection and convulsions. Settings and Design: Prospective randomized and comparative study of 40 ASA I and II patients of age group 6 to 15 years undergoing tonsillectomy under general anaesthesia. Methods and Material: Patients were divided into two groups randomly, group B (Bupivacaine group) – in which 2 cotton pledgets soaked in 0.1ml/kg of 0.5% Bupivacaine was kept in the tonsillar fossa for 5 minutes and group C (control group) which received 2 cotton pledgets soaked in 0.1ml/kg of 0.9% NaCl and kept in fossa for 5 mins. Statistical Analysis Used: One­way ANOVA was used for analyzing the data. For comparing binomial data like sex and ASA status, Chi square test was used. Results: The group with topical bupivacaine had less tonsillar fossa pain and requested postoperative analgesics very lately or not till discharge Conclusion: We conclude that topical application of cotton pledget soaked in 0.5% bupivacaine in tonsillar fossa for 5 minutes is effective in providing relief of post tonsillectomy pain and promote recovery.

Perspectives

Context: Tonsillectomy is the second most common surgical procedure performed in pediatric patients. Post­Tonsillectomy pain is regarded as a major morbidity in early post­operative period which delays the oral intake & discharge of patients. Topical application of Local Anesthetic like Bupivacaine at the site of trauma reduces post­operative pain resulting in early oral intake & early discharge unlike local infiltration in which complication rate is high for intravascular injection and convulsions. Settings and Design: Prospective randomized and comparative study of 40 ASA I and II patients of age group 6 to 15 years undergoing tonsillectomy under general anaesthesia. Methods and Material: Patients were divided into two groups randomly, group B (Bupivacaine group) – in which 2 cotton pledgets soaked in 0.1ml/kg of 0.5% Bupivacaine was kept in the tonsillar fossa for 5 minutes and group C (control group) which received 2 cotton pledgets soaked in 0.1ml/kg of 0.9% NaCl and kept in fossa for 5 mins. Statistical Analysis Used: One­way ANOVA was used for analyzing the data. For comparing binomial data like sex and ASA status, Chi square test was used. Results: The group with topical bupivacaine had less tonsillar fossa pain and requested postoperative analgesics very lately or not till discharge Conclusion: We conclude that topical application of cotton pledget soaked in 0.5% bupivacaine in tonsillar fossa for 5 minutes is effective in providing relief of post tonsillectomy pain and promote recovery.

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This page is a summary of: Role of Intraoperative Topical Application of 0.5% Bupivacaine in Tonsillar Fossa for Postopeartive Analgesia in Tonsillectomy Cases, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.51018.13.
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