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Perioperative local anaesthesia for reducing pain following tonsillectomy
L J Hollis1, M J Burton, J M Millar
1Department of Otolaryngology - Head and Neck Surgery, The Radcliffe Infirmary, Woodstock Road, Oxford, UK, OX2 6HE.
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Local anaesthetics administered before or after tonsillectomy do not appear to improve post-operative pain relief. More high-quality research is needed to confirm these findings for tonsillectomy pain management.
Area of Science:
- Anesthesiology
- Otolaryngology
- Pain Management
Background:
- Post-tonsillectomy pain management is crucial.
- Local anesthetics are sometimes used but their efficacy is unproven.
Purpose of the Study:
- To evaluate the effectiveness of local anesthesia in reducing pain after tonsillectomy.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) up to September 1998.
- Included studies assessed local anesthetic injection or spray before or after tonsillectomy.
- Outcomes measured included time to first analgesia and total analgesia used.
Main Results:
- Six RCTs met inclusion criteria; five used injection, one used spray.
- No significant pain reduction was found with local anesthetics compared to controls.
- Some studies used potentially biased outcome measures.
Conclusions:
- Current evidence does not support perioperative local anesthesia for improved post-tonsillectomy pain control.
- Small study sizes and co-administration of opiates may have confounded results.
- Further rigorous RCTs are required to definitively assess local anesthetic efficacy.