title: Local bupivacaine-epinephrine infiltration combined with general anesthesia for adult tonsillectomy.
abstract: CONCLUSIONS
  Use of a solution of bupivacaine (5 mg/ml)-epinephrine (5 microg/ml) (BE) is beneficial in reducing intraoperative bleeding and decreasing the operation time in adult (adeno)tonsillectomy patients.
  
  
  OBJECTIVE
  Pain and intra- and postoperative bleeding are problems associated with tonsillectomy/adenotonsillectomy. In order to make tonsillectomy/adenotonsillectomy better suited to outpatient surgery, solutions to these problems should be found. One possibility may be the combination of local and general anesthesia. The aim of this study was to find out if such a combination is beneficial in tonsillectomy/adenotonsillectomy.
  
  
  METHODS
  We performed a prospective, randomized, double-blind, controlled study on 64 adult (adeno)tonsillectomy patients to investigate the possible benefits of infiltrating the peritonsillar space with a BE solution.
  
  
  RESULTS
  In the recovery room, the BE group experienced less pain than a control group infiltrated with saline; subsequently there was no significant difference between the groups concerning pain. The average volume of intraoperative bleeding and the operation time were significantly smaller in the BE group. Postoperative bleeding from the tonsillar fossae occurred in 19% (6/31) of the patients in the BE group and in 18% (6/33) in the saline group.
authors.affiliation: Department of Otorhinolaryngology--Head & Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland. robert.ginstrom@welho.com
authors.forename: Robert
authors.initials: R
authors.lastname: Ginström
authors.forename: Juha
authors.initials: J
authors.lastname: Silvola
authors.forename: Laila
authors.initials: L
authors.lastname: Saarnivaara
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D016063:Blood Loss, Surgical; D002045:Bupivacaine; D004311:Double-Blind Method; D004837:Epinephrine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D014068:Tonsillectomy
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine; D004837:Epinephrine