title: A randomised controlled trial of the effect of regional nerve blocks on immediate post-tonsillectomy pain in adult patients.
abstract: Post-operative pain is the main cause of morbidity following tonsillectomy. The efficacy of glossopharyngeal and lesser palatine nerve blocks in controlling postoperative pain in adult patients was investigated prospectively. Patients 16 years and older admitted for elective tonsillectomy were randomised to one of three groups to receive a pre-incisional oropharyngeal injection of 0.5% bupivicaine, a 'dummy' injection of saline or no injection. Dissection tonsillectomy and general anaesthetic techniques were standardized. Postoperative pain was monitored for 24 h. ANOVA, chi2 and Fisher's exact test were used for intergroup comparisons. Ninety-two patients (72 women and 20 men), mean age 22 years were studied. Twenty-nine patients received 0.5% bupivicaine, 30 saline and 33 no pre-incisional injection. The overall mean pain scores of 2.1, 1.9 and 1.9 in the bupivicaine, saline and no injection groups were similar. Glossopharyngeal and lesser palatine 0.5% bupivicaine nerve blocks are not effective in reducing early post-tonsillectomy pain.
authors.affiliation: Departments of Otolaryngology and Anaesthesia, Aberdeen Royal Infirmary, Department of Otolaryngology, Ninewells Hospital and Medical School, Dundee, UK.
authors.forename: H
authors.initials: H
authors.lastname: El-Hakim
authors.forename: D A
authors.initials: DA
authors.lastname: Nunez
authors.forename: H A
authors.initials: HA
authors.lastname: Saleh
authors.forename: D M
authors.initials: DM
authors.lastname: MacLeod
authors.forename: Q
authors.initials: Q
authors.lastname: Gardiner
mesh_terms: D000328:Adult; D000779:Anesthetics, Local; D002045:Bupivacaine; D004311:Double-Blind Method; D005260:Female; D005930:Glossopharyngeal Nerve; D006801:Humans; D008297:Male; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D010160:Palate, Soft / Q000294:innervation; D011446:Prospective Studies; D014068:Tonsillectomy
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine