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Anesthetic injections and analgesia use in pediatric post-tonsillectomy patients: A meta-analysis and systematic

Briana Ortega1, Joshua A Stramiello1, Matthew Brigger2

  • 1University of California San Diego Department of Surgery, Division of Otolaryngology, San Diego, CA, USA.

International Journal of Pediatric Otorhinolaryngology
|November 20, 2021
PubMed

Insights

Intraoperative local anesthetic injection for pediatric tonsillectomy improves initial recovery by delaying the need for pain medication. This method does not increase risks of bleeding or dehydration.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Pain Management

Background:

  • Tonsillectomy is a common pediatric surgical procedure.
  • Effective post-operative pain management is crucial for recovery.
  • The role of local anesthetics in pediatric tonsillectomy pain control requires further evaluation.

Purpose of the Study:

  • To evaluate the impact of intraoperative local anesthetic injection on post-operative pain relief and complications in pediatric tonsillectomy.
  • To assess the effect on the need for opioid analgesia on post-operative days 0 and 1.

Main Methods:

  • Systematic review and meta-analysis adhering to PRISMA guidelines.
  • Searched databases: PubMed, Embase, Web of Science, Scopus.
  • Included studies with original data and saline control arms; contacted authors for missing data.

Main Results:

  • Analyzed 8 studies with 529 participants comparing local anesthetic to saline injection.
  • Local anesthetic significantly reduced the time to first analgesic (SMD 0.68 min, P=0.001).
  • Reduced odds of receiving narcotic medication on post-operative day 0 (OR 0.22, P=0.03).

Conclusions:

  • Intraoperative local anesthetic injection aids initial recovery after pediatric tonsillectomy.
  • It delays the need for narcotic medication and may decrease usage on post-operative days 0 and 1.
  • Local anesthesia does not elevate the risk of post-operative bleeding or dehydration.
Abstract

Keywords:
AnalgesiaAnesthetic injectionNarcoticPediatricTonsillectomy

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