Effect of peritonsillar prilocaine infiltration on post-tonsillectomy pain in pediatric population

Year 2021, Volume: 46 Issue: 3, 1094 - 1099, 30.09.2021

Burak Mustafa Taş , Burak Erden , Gökçe Şimşek

https://doi.org/10.17826/cumj.910794

Abstract

Purpose: This study aims to evaluate the efficacy of peritonsillar prilocaine in post-tonsillectomy pain by using the Visual Analog Scale (VAS).
Materials and Methods: A total of 40 pediatric patients were included in this study. There were 20 patients in the prilocaine group (Group 1) and 20 patients in the control group (Group 2). In Group 1, peritonsillar prilocaine infiltration was performed. In Group 2, peritonsillar saline infiltration was performed. VAS scores of at the postoperative 1st, 4th, 12th and 24th hours and on the 2nd, 3rd, 4th, 5th, 6th and 7th days were evaluated. In addition, the presence of nausea and vomiting and the number of additional doses of intravenous paracetamol administered in the first 24 hours were evaluated.
Results: When the groups were compared, a significant reduction in post-tonsillectomy pain was observed in the prilocaine group at the 1st, 4th and 12th hours compared to the control group. There was no significant difference between the two groups in other scores. There was no significant difference between the groups for nausea and vomiting and consumption of paracetamol values.
Conclusion: Peritonsillar prilocaine infiltration was effective in post-tonsillectomy pain at the 1st, 4th and 12th hours postoperatively. Thus, peritonsillar prilocaine infiltration can be used in post-tonsillectomy pain because it is fast and effective.

Keywords

Peritonsillar infiltration, Post-tonsillectomy pain, Prilocaine, Tonsillectomy, Visual Analog Scale

Pediatrik popülasyonda peritonsiller prilokain infiltrasyonunun tonsillektomi sonrası ağrıya etkisi

Abstract

Amaç: Bu çalışma, peritonsiller prilokainin tonsillektomi sonrası ağrıda etkinliğini Vizüel Analog Skala (VAS) kullanarak değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Bu çalışmaya toplam 40 pediatrik hasta dahil edildi. Prilokain grubunda (Grup 1) 20, kontrol grubunda (Grup 2) 20 hasta vardı. Grup 1'de peritonsiller prilokain infiltrasyonu yapıldı. Grup 2'de peritonsiller salin infiltrasyonu yapıldı. Postoperatif 1., 4., 12. ve 24. saatlerde ve 2., 3., 4., 5., 6. ve 7. günlerde VAS skorları değerlendirildi. Ek olarak, bulantı ve kusma varlığı ve ilk 24 saatte uygulanan intravenöz parasetamolün ek doz sayısı değerlendirildi.
Bulgular: Gruplar karşılaştırıldığında prilokain grubunda 1., 4. ve 12. saatlerde kontrol grubuna göre tonsillektomi sonrası ağrıda anlamlı azalma gözlendi. Diğer puanlarda iki grup arasında anlamlı bir fark yoktu. Bulantı kusma ve parasetamol tüketimi açısından gruplar arasında anlamlı fark yoktu.
Sonuç: Çalışmamızda peritonsiller prilokain infiltrasyonunun postoperatif 1., 4. ve 12. saatlerde tonsillektomi sonrası ağrıda etkili olduğunu buldukBu nedenle, peritonsiller prilokain infiltrasyonunun hızlı ve etkili olması nedeniyle tonsillektomi sonrası ağrıda kullanılabileceğini düşünüyoruz.

Keywords

Peritonsiller infiltrasyon, Post-tonsillektomi ağrı, Prilokain, Tonsillektomi, Vizüel Analog Skala

References

• 1. Cohen N, Sommer DD. Post-tonsillectomy pain control: consensus or controversy? Pain Manag. 2016; 6(1):31-7.
• 2. Patel HH, Straight CE, Lehman EB, Tanner M, Carr MM. Indications for tonsillectomy: a 10-year retrospective review. Int. J. Pediatr. Otorhinolaryngol. 2016; 78(12), 2151–2155.
• 3. Neri G, Baffa C, Vitullo F, Di Mascio R, Ballone E. Single-Blind Evaluation of Post-Tonsillectomy Pain Treatment with an Eutectic Mixture of Local Anesthetics. European Journal of Inflammation. 2006:181-189.
• 4. Grainger J, Saravanappa N. Local anaesthetic for post-tonsillectomy pain: a systematic review and meta-analysis. Clin Otolaryngol. 2008; 33(5):411-9.
• 5. Hollis L.J., Burton M.J., Millar J.M. 2000. Perioperative local anaesthesia for reducing pain following tonsillectomy. Cochrane Database of Systematic Reviews Issue 4 art. No. CD001874.
• 6. Kilinc L., Türk B., Türk H.S. et al. Peritonsillar dexamethasone–bupivacaine vs. bupivacaine infiltration for post-tonsillectomy pain relief in children: a randomized, double-blind, controlled study. Eur Arch Otorhinolaryngol 2019; 276, 2081–2089.
• 7. Yap D, Ng M, Moorthy R. #10-Year Challenge: Local anaesthetic for post-tonsillectomy pain: Update meta-analysis. Clin Otolaryngol. 2020; 45(4):517-528. 8. Tetzlaff JE. The pharmacology of local anesthetics. Anesthesiol Clin North Am. 2000; 18(2):217-33, v.
• 9. Boublik J, Gupta R, Bhar S, Atchabahian A. Prilocaine spinal anesthesia for ambulatory surgery: A review of the available studies. Anaesth Crit Care Pain Med. 2016; 35(6):417-421.
• 10. Apuhan T, Yildirim YS, Gulcu N, Koçoglu H, Karagöz Y. The effect of prilocaine or levobupivacaine infiltration on pain during nasal packing removal. Otolaryngol Head Neck Surg. 2011; 145(3):418-21.
• 11. Özkiriş M, Aydin R, Gencer ZK, Saydam L. Comparison of topical anesthetic effects of lidocaine, prilocaine, ropivacaine, and bupivacaine in transnasal fiberoptic nasopharyngolaryngoscopy. Am J Rhinol Allergy. 2014; 28(3):e141-3.
• 12. Molliex S, Haond P, Baylot D, Prades JM, Navez M, Elkhoury Z, Auboyer C. Effect of pre- vs postoperative tonsillar infiltration with local anesthetics on postoperative pain after tonsillectomy. Acta Anaesthesiol Scand. 1996; 40(10):1210-5.
• 13. Unal Y, Pampal K, Korkmaz S, Arslan M, Zengin A, Kurtipek O. Comparison of bupivacaine and ropivacaine on postoperative pain after tonsillectomy in paediatric patients. Int J Pediatr Otorhinolaryngol. 2007; 71(1):83-7.
• 14. Ozkiriş M, Kapusuz Z, Saydam L. Comparison of ropivacaine, bupivacaine and lidocaine in the management of post-tonsillectomy pain. Int J Pediatr Otorhinolaryngol. 2012; 76(12):1831-4.
• 15. Alsharif A, Omar E, Alolayan AB, Bahabri R, Gazal G. 2% lidocaine versus 3% prilocaine for oral and maxillofacial surgery. Saudi J Anaesth. 2018; 12(4):571-577.
• 16. Gazal G. Is prilocaine safe and potent enough for use in the oral surgery of medically compromised patients. Saudi Med J. 2019; 40(1):97-100.