Tonsillectomy pain control with IV dexamethasone, infiltrated dexamethasone and infiltrated bupivacaine; a randomised, double-blind, placebo controlled, prospective clinical trial

Abstract

Objective: To compare effects of local and systemic administrations of dexamethasone and local bupivacaine on postoperative pain in patients who have had tonsillectomy..

Methods: This randomised, double-blinded, placebo-controlled and prospective clinical trial was conducted at Adana Numune Training and Research Hospital, Turkey, between April and July 2016, and comprised patients who were undergoing tonsillectomy operation due to recurrent tonsillitis, chronic tonsillitis or tonsillar hypertrophy indication. Patients were randomly assigned to 4 equal groups. Group 1 was administered 0.5 mg/kg intravenous dexamethasone. Group 2 was given 0,5mg/kg dexamethasone diluted with 10 mL saline which was infiltrated into the peritonsillar regions. Group 3 received 2.5 mL of 0.5% bupivacaine infiltration. Group 4 was the control group and received peritonsillar saline infiltration. Pain was evaluated with visual analogue scale and the data obtained was analysed with SPSS 20..

Results: Of the 60 patients, each group had 15(25%). Visual analogue scale values at the 15th minute was significantly lower in Group 1 compared to the other groups (p<0.05). Values of Group 4 were higher from the 1st hour through to the 24th hour compared to the other groups (p<0.05). Although there were no significant differences among the other groups, the lowest value of visual analogue scale was found in Group 1 in the 6th hour (p>0.05). Values of Group 4 at the 6th and 12th hours were significantly higher compared to Groups 1 and 2 (p<0.05).

Conclusions: Intravenous dexamethasone, infiltrated dexamethasone and infiltrated bupivacaine were all found to be effective on postoperative pain.

Keywords: Tonsillectomy, Pain, Dexamethasone, Bupivacaine..