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Category: Volume 07 Issue 05 May 2019
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Title: A Randomised double blind clinical trial to compare the effects of preincisional infiltration of ropivacaine v/s bupivacaine on post tonsillectomy pain relief

Author: Dr Manvi Mehta

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.96

Abstract

Objectives: To determine whether pre incisional infiltration of ropivacaine will be effective in reducing post-operative pain intensity comparable to bupivacaine.

Patient & Methods: Prospective, randomised, double blind clinical trial at Lady Hardinge Medical College, ENT Department. Sixty children, aged 5-12 years, undergoing tonsillectomy were included in the study. Patients in one of the groups received 0.375% of ropivacaine infiltration in the tonsillar fossa while the other group received 0.25% of bupivacaine infiltration 5 minutes prior to incision. Wong Baker faces pain rating scale was used to compare two groups in respect of pain control. Unpaired student t-test were used to compare the two independent groups, p< 0.005 was considered statistically significant.

Results: In the postoperative hours there was a statistically significant pain relieving effect seen in ropivacaine group (p<0.0001). in the other postoperative parameters such as nausea, fever, vomiting, bleeding, trismus, otalgia were not statistically different between two groups. There were no complications associated with ropivacaine or bupivacaine. No patients in the study suffered from any systemic side effects related to use of medication.

Conclusion: Locally infiltrating ropivacaine significantly relieves the pain of paediatric post tonsillectomy patients compared to equipotent dose of bupivacaine. Also ropivacaine is more effective to reduce postop analgesic requirement in the 1st hour and overall analgesic requirement. 

Keywords: Tonsillectomy, Ropivacaine, Bupivacaine.

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Corresponding Author

Dr Manvi Mehta

Delhi University