The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and Bleeding

Introduction: Tonsillectomy is one of the most common surgeries in the world and the most common problem is post-tonsillectomy pain and bleeding. The relief of postoperative pain helps increase early food intake and prevent secondary dehydration. One method for relieving pain is peritonsillar inject...

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Main Authors: Ali Reza Bameshki, Marzieh Razban, Ehsan Khadivi, Majid Razavi, Mehdi Bakhshaee
Format: Article
Language:English
Published: Mashhad University of Medical Sciences 2013-10-01
Series:Iranian Journal of Otorhinolaryngology
Subjects:
Online Access:http://ijorl.mums.ac.ir/pdf_1369_387942a5f9a142b1507eb3755f68e756.html
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author Ali Reza Bameshki
Marzieh Razban
Ehsan Khadivi
Majid Razavi
Mehdi Bakhshaee
author_facet Ali Reza Bameshki
Marzieh Razban
Ehsan Khadivi
Majid Razavi
Mehdi Bakhshaee
author_sort Ali Reza Bameshki
collection DOAJ
description Introduction: Tonsillectomy is one of the most common surgeries in the world and the most common problem is post-tonsillectomy pain and bleeding. The relief of postoperative pain helps increase early food intake and prevent secondary dehydration. One method for relieving pain is peritonsillar injection of epinephrine along with an anesthetic, which has been shown to produce variable results in previous studies. Study Deign: Prospective case-control study. Setting: A tertiary referral centers with accredited otorhinolaryngology-head & neck surgery and anesthesiology department.   Materials and Methods: Patients under 15 years old, who were tonsillectomy candidates, were assigned into one of three groups: placebo injection, drug injection before tonsillectomy, and drug injection after tonsillectomy. The amount of bleeding, intensity of pain, and time of first post-operative food intake were evaluated during the first 18 hours post operation.    Results: The intensity of pain in the first 30 minutes after the operation was lower in the patients who received injections, but the difference was not significant during the first 18 hours. The intensity of pain on swallowing during the first 6 hours was also lower in the intervention groups as compared with the placebo group. The amount of bleeding during the first 30 minutes post operation was lower in the two groups who received injections, but after 30 minutes there was no difference.   Conclusion:  Injection of epinephrine and bupivacaine pre- or post- tonsillectomy is effective in reducing pain and bleeding. The treatment also decreases swallowing pain in the hours immediately after surgery.
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spelling doaj.art-f58b60ae1ac34342a5bb078d6ffe6c4e2022-12-22T03:05:01ZengMashhad University of Medical SciencesIranian Journal of Otorhinolaryngology2251-72512251-726X2013-10-0125732092131369The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and BleedingAli Reza Bameshki0Marzieh Razban1Ehsan Khadivi2Majid Razavi3Mehdi Bakhshaee4Cardiac Anesthesia Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Otorhinolaryngolog, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.Sinus and Surgical Endoscopic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranCardiac Anesthesia Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Sinus and Surgical Endoscopic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranIntroduction: Tonsillectomy is one of the most common surgeries in the world and the most common problem is post-tonsillectomy pain and bleeding. The relief of postoperative pain helps increase early food intake and prevent secondary dehydration. One method for relieving pain is peritonsillar injection of epinephrine along with an anesthetic, which has been shown to produce variable results in previous studies. Study Deign: Prospective case-control study. Setting: A tertiary referral centers with accredited otorhinolaryngology-head & neck surgery and anesthesiology department.   Materials and Methods: Patients under 15 years old, who were tonsillectomy candidates, were assigned into one of three groups: placebo injection, drug injection before tonsillectomy, and drug injection after tonsillectomy. The amount of bleeding, intensity of pain, and time of first post-operative food intake were evaluated during the first 18 hours post operation.    Results: The intensity of pain in the first 30 minutes after the operation was lower in the patients who received injections, but the difference was not significant during the first 18 hours. The intensity of pain on swallowing during the first 6 hours was also lower in the intervention groups as compared with the placebo group. The amount of bleeding during the first 30 minutes post operation was lower in the two groups who received injections, but after 30 minutes there was no difference.   Conclusion:  Injection of epinephrine and bupivacaine pre- or post- tonsillectomy is effective in reducing pain and bleeding. The treatment also decreases swallowing pain in the hours immediately after surgery.http://ijorl.mums.ac.ir/pdf_1369_387942a5f9a142b1507eb3755f68e756.htmlBleedingBupivacaineEpinephrinePost-tonsillectomy painPost-tonsillectomyTonsillectomy
spellingShingle Ali Reza Bameshki
Marzieh Razban
Ehsan Khadivi
Majid Razavi
Mehdi Bakhshaee
The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and Bleeding
Iranian Journal of Otorhinolaryngology
Bleeding
Bupivacaine
Epinephrine
Post-tonsillectomy pain
Post-tonsillectomy
Tonsillectomy
title The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and Bleeding
title_full The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and Bleeding
title_fullStr The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and Bleeding
title_full_unstemmed The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and Bleeding
title_short The Effect of Local Injection of Epinephrine and Bupivacaine on Post-Tonsillectomy Pain and Bleeding
title_sort effect of local injection of epinephrine and bupivacaine on post tonsillectomy pain and bleeding
topic Bleeding
Bupivacaine
Epinephrine
Post-tonsillectomy pain
Post-tonsillectomy
Tonsillectomy
url http://ijorl.mums.ac.ir/pdf_1369_387942a5f9a142b1507eb3755f68e756.html
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