Bupivacaine infiltration in children for postoperative analgesia after tonsillectomy: A randomised controlled trial

摘要: BACKGROUND Adenotonsillectomy is a frequently performed procedure in paediatric day-case surgery. Postoperative pain can be significant and standard analgesia protocols are often insufficient. OBJECTIVE Our primary objective was to investigate if infiltration of the peritonsillar space with bupivacaine would reduce need for postoperative opioids compared pre-emptive intravenous tramadol. DESIGN A double-blind, randomised controlled trial. SETTING Ambulatory surgical day care centre, University Hospitals Leuven, Belgium, from January 2012 September 2016. PATIENTS Two hundred children, between 4 10 years old, undergoing elective adenotonsillectomy were included study. INTERVENTION Children randomly allocated receive either bolus 3 mg kg tramadol or tonsillar lodge 5-ml 0.25%. Reasons exclusion American Society Anesthesiologists classification greater than 2, allergies investigated products, psychomotor retardation, bleeding disorders lack proficiency Flemish. MAIN OUTCOME MEASURES The endpoint number children piritramide postoperatively. Secondary outcomes cumulative dose piritramide, scores incidence nausea vomiting during first 24 hours, time discharge adverse effects. RESULTS proportion significantly lower group (57 vs. 81%, P < 0.001). When tramadol-group required (median [IQR] 0.7 [0.6 1] 1 1.5] mg, P < 0.007) had 60 min after There no statistically differences incidence, antiemetics complications. CONCLUSION Compared infiltration, preemptive decreases tonsillectomy without increasing side TRIAL REGISTRATION EudraCT 2011-005467-25.