Adjuvant local anaesthetics in the epipharyngeal space in day-case adenoidectomy: a prospective, randomized, double-blind, placebo-controlled trial.
CONCLUSIONS
Mepivacaine applied in the epipharyngeal space as an adjuvant local anaesthetic does not reduce postoperative pain after adenoidectomy in children given high-dose paracetamol preoperatively.


OBJECTIVE
To evaluate the pain-reducing effect of an adjuvant local anaesthetic (mepivacaine) applied in the epipharyngeal space after outpatient adenoidectomy.


METHODS
This was a prospective, randomized, double-blind, placebo-controlled trial. Postoperative pain was assessed in 98 children aged 3-10 years using a visual analogue scale (VAS) and the Wong-Baker FACES pain rating scale. The time between the end of surgery and discharge from hospital was recorded, as well as the need for extra pain medication in addition to the high-dose paracetamol (acetaminophen) that had been given preoperatively. Serum levels of mepivacaine were analysed in 10 consecutive patients.


RESULTS
No difference was seen between the mepivacaine and control groups regarding postoperative pain as estimated using either the VAS or the Wong-Baker FACES pain rating scale. There were also no differences between the groups concerning the time to discharge from hospital and the need for extra pain medication before discharge. No mepivacaine could be detected in the patients' sera.
Knutsson
Johan
J
Department of Otorhinolaryngology, Västerås Central Hospital, Västerås, Sweden. johan.knutsson@ltv.se
Tibbelin
Anders
A
Von Unge
Magnus
M
D000233:Adenoidectomy / Q000009:adverse effects; D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care; D010614:Pharynx; D011446:Prospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008619:Mepivacaine