Comparing the effect of ropivacaine peritonsillar injection before and after adenotonsillectomy on postoperative pain among pediatric patients: A double-blind randomized clinical trial

Abstract

Objectives

Ropivacaine local injection is a preventative management option for post-adenotonsillectomy pain. The effectiveness of this approach varies depending on the time of drug administration. This study is aimed to evaluate pre-emptive effect of administration of Ropivacaine before vs. after adenotonsillectomy.

Methods

In this study, children aged 3–12 years who were diagnosed with chronic tonsillitis candidates for elective adenotonsillectomy surgery randomly assigned to one of three randomized groups. Participants in the first group got a peritonsillar injection of 3 mg/kg Ropivacaine 1 % before the surgery, patients in the second group received 3 mg/kg Ropivacaine 1 % peritonsillar injection after surgery, and patients in the control group received peritonsillar injections of 5 cc normal saline. Postoperative pain was assessed using the Wong-Baker Pain Scale. SPSS software was used to perform statistical analysis.

Results

Among total of 99 enrolled cases, mean age of 7.29 ± 2.61 years, participants who received Ropivacaine before surgery experienced significantly less postoperative pain four, eight, and 24 h after surgery (P = 0.001). In addition, compared to other groups, these patients consumed significantly less analgesics during postoperative hospitalization and after discharge (p < 0.001 and = 0.001 respectively).

Conclusion

Ropivacaine peritonsillar injection before adenotonsillectomy may be more beneficial than Ropivacaine injection after surgery for postoperative pain management among children undergoing adenotonsillectomy.