Effect of Intraoperative Infiltration of Local Anaesthetic Agent on Post-tonsillectomy Pain

Tonsillectomy is one of the most commonly performed surgeries in Otolaryngology practice. Despite improvements in anesthetic and surgical techniques, post-tonsillectomy morbidities especially pain continue to be a significant clinical concern. This prospective, double blind, Randomized Controlled Trial (RCT) was conducted at Department of ENT and Head-Neck surgery, Dhaka Medical College Hospital, Bangladesh from January 2021 to June 2022. Total 100 patients were enrolled through non-probability purposive sampling and according to the selection criteria, who were admitted for elective tonsillectomy. They were randomly allocated into two groups of 50 persons each- 'Intra-operative local infiltration of Bupivacaine' (B) and 'Normal saline' (N) group according to intervention applied on them. A significantly lower score on Wong-Baker Faces Pain rating scale (WBS) was found in group 'B' comparing with group 'N' at 4, 6 and 8 hours interval after the surgery. Group 'B' patients started their oral intake significantly sooner than group 'N' patients. On analysis Pre-incisional peritonsillar infiltration of 0.5% Bupivacaine hydrochloride is a safe and effective method to reduce early post-tonsillectomy pain. This intervention is also effective for earlier start of oral feeding and to decrease in the incidence of post-operative morbidities.