POST TONSILIECTOMY ANALGESIA USING BUPIVACAINE WITH EVALUATION OF ITS SERUM LEVEL A PRE - EMPTIVE AND POSTOPERATIVE STUDY

Abstract

To test the hypothesis that blockade of nociceptive input with bupivacaine during tonsillectomy can decrease pain beyond the immediate postoperative period, our study was designed to compare the effects of bupivacaine 0.5% with 1 : 200.000 epinephrine administered either preoperative (pre-incisional infiltration) or postoperative infiltration or spray on control of postoperative pain in children. 80 children aged 6-12 years, ASA physical status 1-2, scheduled for elective tonsillectomy in E.N.T. operative theatre in Assiut university Hospital were enrolled in this study. The induction of anaesthesia in all groups was induced by i.v. thiopentone4 mg-kg.- 1 with atropine 0.02 mg-kg.- 1.

Succinylcholine 2 mg-kg.-1 was used to facilitate endotracheal intubation. Anaesthesia was maintained with 50% nitrous oxide to oxygen and 2% fluthane. Patients were randomly divided into 4 groups, the 1st group, (pre-emptive group) received 2 mg-kg.-1 bupivacaine 0.5% with epinephrine 1 : 200.000 by peritonsillar infiltration after induction of anaesthesia and before start of surgery by 5 min. The 2nd group, (postoperative infiltration group) received 2 mg-kg."1 bupivacaine 0.5% with epinephrine 1:200.000 by peritonsillar infiltration at completion of surgery and after haemostasis was achieved. The 3rd group,