title: Inclusion of pethidine in lidocaine for infiltration improves analgesia following tonsillectomy in children.
abstract: BACKGROUND
  Previous work has demonstrated that pethidine exerts local anaesthetic effects on peripheral nerves in vivo. We examined the effects of infiltration anaesthesia by a combination of pethidine and lidocaine on post-tonsillectomy pain and restlessness in children.
  
  
  METHODS
  Eighty children were randomly allocated to receive peritonsillar infiltration postoperatively with 3 ml of lidocaine 2% (1.5 ml on each side) combined with either 0.1 ml pethidine, 10 mg.ml-1, (pethidine group) or 0.1 ml normal saline (control group). Pain and behaviour were assessed at 1, 3, 6 and 12 h postoperatively and on the following morning by the patients and by a nurse blinded to previous treatment.
  
  
  RESULTS
  Patients in the pethidine group had lower pain scores than those in the control group at rest as well as swallowing during the whole observation period (P < 0.05). Paracetamol was given to 34/40 children in the control group and to 6/40 children in the pethidine group. The corresponding figures for pethidine administration were 6/40 and 0/40, respectively. Patients in the pethidine group displayed a more rapid return to calm wakefulness than those in the control group (P < 0.01).
  
  
  CONCLUSIONS
  Inclusion of a low dose of pethidine in lidocaine for tonsillar infiltration improves pain relief after tonsillectomy in children.
authors.affiliation: Department of Anaesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: Elhakim
authors.forename: A Y
authors.initials: AY
authors.lastname: Abdul Salam
authors.forename: A
authors.initials: A
authors.lastname: Eid
authors.forename: N
authors.initials: N
authors.lastname: Kaschef
authors.forename: B E
authors.initials: BE
authors.lastname: Mostafa
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008614:Meperidine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011292:Premedication; D014068:Tonsillectomy
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008012:Lidocaine; D008614:Meperidine