Background and Aims Tonsillectomy is a common surgical intervention performed in the pediatric population, and post-operative pain is the main cause of morbidity following surgery [1,2]. Due to its innervation, lesser palatine nerve block (LPNB) may alleviate post-tonsillectomy pain. In this study, we evaluated the effect of the LPNB on postoperative analgesia in children undergoing adenotonsillectomy.
Methods Following informed consent, consecutive pediatric patients presented for adenotonsillectomy were randomly assigned to one of two groups: the intervention group receiving a bilateral LPNB (1–3 ml Ropivacaine 0.375%), and a control group. Both groups received the same iv analgesic intraoperative (fentanyl, paracetamol and tramadol) and postoperative (pethidine) protocol. Variables analyzed included postoperative pain scores (NRS) in the immediate postoperative period, time to rescue analgesia, total pethidine needs and PACU stay. Data analyzed using IBM-SPSS Statistics; Spearman correlation, Kruskal-Wallis, Chi-square or Fisher tests where appropriate (p<0,01).
Results A total of 42 patients were included in the analysis. No statistical difference was found between groups concerning demographic data, intra-operative analgesic doses, maximum NRS pain evaluations, rescue analgesia or PACU stay (Table 1). A significant correlation was found between maximum NRS pain scores and rescue analgesia in the PACU, as would be expected (Figure 1).
Conclusions In the studied population and considering the multimodal analgesia protocol used, the LPNB, does not seem improve postoperative pain control, or to reduce PACU rescue analgesia. Further studies would be necessary, with a larger sample size, to discern differences between groups .
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