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Peritonsillar Ropivacaine Infiltration in Paediatric Tonsillectomy: A Randomised Control Trial
Arvinder-Singh Sood1, Pooja Pal1, Gurupreet-Singh Gill1
1Department of Otorhinolaryngology, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India - 143001.
Insights
Ropivacaine infiltration effectively reduces post-tonsillectomy pain in children. This randomized controlled study found significantly lower pain scores and improved swallowing in patients receiving Ropivacaine compared to saline.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Surgical Outcomes
Background:
- Post-tonsillectomy pain is a significant challenge in pediatric care.
- Effective pain management strategies are crucial for recovery and patient well-being.
Purpose of the Study:
- To evaluate the efficacy and safety of Ropivacaine for post-operative pain management in children undergoing tonsillectomy.
- To compare Ropivacaine infiltration with normal saline in controlling post-tonsillectomy pain.
Main Methods:
- A randomized controlled study involving 140 pediatric patients (4-12 years) undergoing tonsillectomy.
- Patients received tonsillar fossa infiltration with 0.2% Ropivacaine or 0.9% normal saline.
- Pain was assessed using the Wong Baker's Faces Scoring System at multiple intervals up to 48 hours post-operatively.
Main Results:
- Ropivacaine group showed significantly lower pain scores at 48 hours post-operation (P<0.01).
- Mean deglutition time was significantly reduced in the Ropivacaine group (P<0.01).
- No significant difference in age and sex distribution between the groups.
Conclusions:
- Ropivacaine infiltration is an effective method for managing post-tonsillectomy pain in children.
- The use of Ropivacaine demonstrated minimal side-effects in the study population.
- Ropivacaine offers a promising approach to improve pediatric post-surgical recovery.
Introduction:
Various efforts have been made to reduce post tonsillectomy pain in children. The present study was undertaken to evaluate the efficacy and safety of Ropivacaine in post-operative pain management in these children.
Materials And Methods:
This study is a Randomized control study on 140 patients between 4 - 12 years of age, in whom tonsillectomy was performed in a tertiary care centre between January 2017 to November 2018 using standard dissection and snare surgical technique. Postoperatively, patients were randomized into 2 groups of 70 patients each, receiving tonsillar fossa infiltration with 0.2% Ropivacaine or 0.9% normal saline respectively. Patients were assessed as per Wong Baker's Faces Scoring System at 2 hours, 4 hours, 8 hours, 18 hours, 24 hours, and 48 hours postoperatively. All the results were analyzed by SPSS software. Chi- square test and Mann-Whitney test were used for assessment of level of significance, with P- value of less than 0.05 taken as significant.
Results:
Both the groups were comparable with respect to age and sex. At 48 hours, in study group, maximum number of patients 35 (50%) had Wong Baker score 0, while in control group, maximum number of patients 52 (74.3%) had Wong Baker score 4 (P< 0.01). The difference in the mean Deglutition time between both groups was significant (P< 0.01).
Conclusion:
Ropivacaine infiltration is a effective modality for post-tonsillectomy pain management in children, with minimal side-effects.
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