Post-tonsillectomy pain and bupivacaine, an intra individual design study

To compare whether an individual could appreciate the pain relief, if any, in either one of his/her tonsillar fossa topically suffused with a local anaesthetic (bupivacaine).

Randomized controlled trial.

Department of ENT/Head and Neck Surgery, Combined Military Hospital, Peshawar, from January to June 2007.

Forty-six patients of either gender, aged 10-42 years undergoing tonsillectomy for recurrent tonsillitis were enrolled for this study. At the end of surgery, having secured haemostasis, one tonsillar fossa was randomly packed with a gauze piece soaked in 3 ml of 0.5% bupivacaine for 5 minutes, while the other was not. Effects of postoperative analgesia were assessed using visual analogue scale (VAS) up to 8 hours.

Majority of the patients (85%, n=39) failed to experience an appreciable pain relief on the side of local anaesthetic (bupivacaine) application (p=0.006).

Topical application of local anaesthetic (bupivacaine) confers no appreciable pain control in post-tonsillectomy patients.