Role of Bupivacaine in reducing post tonsillectomy pain

P Bhadoria1, P K Rathore, S Mandal

  • 1Maulana Azad Medical College and associated, L.N. Hospital, 110002 New Delhi.

Insights

Pre-incisional Bupivacaine infiltration into the tonsillar fossa provided immediate pain relief for children after tonsillectomy. However, this pain management method only lasted for four to six hours post-operation.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery

Background:

  • Post-tonsillectomy pain is a significant concern for patients, surgeons, and anesthesiologists.
  • Pre-incisional Bupivacaine infiltration is a technique explored for managing post-operative pain in pediatric tonsillectomy patients.

Purpose of the Study:

  • To evaluate the efficacy of pre-incisional Bupivacaine infiltration in the tonsillar fossa for managing immediate post-operative pain in children undergoing tonsillectomy.

Main Methods:

  • Children undergoing tonsillectomy received pre-incisional Bupivacaine infiltration into the tonsillar fossa.
  • Post-operative pain levels were assessed in the immediate post-operative period.

Main Results:

  • Pre-incisional Bupivacaine infiltration provided immediate post-operative pain relief.
  • The analgesic effect of Bupivacaine infiltration lasted for a duration of four to six hours.

Conclusions:

  • While pre-incisional Bupivacaine infiltration offers initial pain relief, its short duration necessitates further investigation for prolonged pain management strategies in pediatric tonsillectomy.

Related Concept Videos

Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...