Post-Tonsillectomy Pain and Bupivacaine, An Intra Individual Design Study

Objective: To compare whether an individual could appreciate the pain relief, if any, in either one of his/her tonsillar fossa topically suffused with a local anaesthetic (bupivacaine). Study Design: Randomized controlled trial. Place and Duration of Study: Department of ENT/Head and Neck Surgery, Combined Military Hospital, Peshawar, from January to June 2007. Methodology: Forty-six patients of either gender, aged 10-42 years undergoing tonsillectomy for recurrent tonsillitis were enrolled for this study. At the end of surgery, having secured haemostasis, one tonsillar fossa was randomly packed with a gauze piece soaked in 3 ml of 0.5% bupivacaine for 5 minutes, while the other was not. Effects of postoperative analgesia were assessed using visual analogue scale (VAS) up to 8 hours. Results: Majority of the patients (85%, n=39) failed to experience an appreciable pain relief on the side of local anaesthetic (bupivacaine) application (p=0.006). Conclusion: Topical application of local anaesthetic (bupivacaine) confers no appreciable pain control in post-tonsillectomy patients.