Addition of magnesium sulfate to bupivacaine improves analgesic efficacy after tonsillectomy: A randomized trial and...

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pain Management

Background:

• Post-tonsillectomy pain is a significant concern in pediatric patients.
• Effective pain management strategies are crucial for recovery and patient well-being.

Purpose of the Study:

• To compare the efficacy of magnesium sulphate and bupivacaine wound infiltration versus bupivacaine alone and saline in managing pediatric post-tonsillectomy pain.
• To assess the impact of magnesium sulphate on preventing laryngospasm and reducing nausea/vomiting post-tonsillectomy.

Main Methods:

• A prospective, double-blind, randomized clinical trial involving 75 children undergoing tonsillectomy.
• Patients were randomized into three groups: saline, bupivacaine alone, or magnesium sulphate with bupivacaine, infiltrated into the peritonsillar fossa.
• Pain was assessed using the modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS), and adverse events like laryngospasm, nausea, and vomiting were monitored.

Main Results:

• The magnesium sulphate and bupivacaine group showed significantly lower mCHEOPS scores compared to the bupivacaine alone and saline groups (P<0.001).
• This group also experienced a longer time to first analgesic administration and lower consumption of additional analgesics (P<0.001).
• No episodes of laryngospasm were observed in the magnesium sulphate group, while nausea and vomiting incidence was not significantly different across groups (P=0.628).

Conclusions:

• Combining magnesium sulphate with bupivacaine provides superior pain control after tonsillectomy in children compared to bupivacaine alone.
• The adjunct of magnesium sulphate may help prevent laryngospasm.
• Further research with larger sample sizes is recommended to confirm these findings with absolute certainty.