Ropivacaine peritonsillar infiltration for analgesia after adenotonsillectomy in children: a randomized, double-blind, placebo-controlled study.
Author(s): Gemma M, Piccioni LO, Gioia L, Beretta L, Bussi M
Affiliation(s): Anesthesia and Intensive Care Unit for Head and Neck Surgery, Scientific Institute Hospital S. Raffaele, Milan, Italy.
Publication date & source: 2009-03, Ann Otol Rhinol Laryngol., 118(3):227-31.
Publication type: Randomized Controlled Trial
OBJECTIVES: Our randomized, double-blind, placebo-controlled study evaluates the possible benefit of peritonsillar infiltration with 0.75% ropivacaine hydrochloride on the pain level after adenotonsillectomy in 3- to 7-year-old children. METHODS: We randomly administered intraoperative peritonsillar infiltration with 0.2 mL/kg ropivacaine 0.75% (group R) or 0.2 mL/kg saline 0.9% (group F) to sixty 3- to 7-year-old children (ASA 1 or 2) who were undergoing adenotonsillectomy. Postoperative pain was assessed 6 and 24 hours after surgery by a 6-face Faces Pain Scale that allowed quantification of pain on a 100-mm horizontal line (0 = no pain). The number of rectal doses of acetaminophen-codeine required during the first postoperative day was recorded. RESULTS: The pain scores did not differ between the groups, either 6 or 24 hours after surgery (group F, 43 +/- 26, versus group R, 29 +/- 23, and group F, 24 +/- 23, versus group R, 30 +/- 28, respectively). Acetaminophen-codeine doses were similarly required in the two groups. CONCLUSIONS: Peritonsillar infiltration with 0.75% ropivacaine does not provide any major postoperative analgesic effect in 3- to 7-year-old children after adenotonsillectomy. A possible clinically minor analgesia 6 hours after surgery is suggested.
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