Comparison of pre-emptive tonsillar lodge infiltration with ropivacaine versus intravenous tramadol in pediatric tonsillectomies: A randomized placebo controlled study

被引:20
|
作者
Cocelli, L. Pirbudak [3 ]
Ugur, B. Kaya [2 ]
Durucu, C. [1 ]
Kul, S. [5 ]
Arik, H. [4 ]
Mumbuc, S.
机构
[1] Gaziantep Univ, Tip Fak Sahinbey Hast, KBBAD, Sch Med,Dept Otolaryngol Head & Neck Surg, Gaziantep, Turkey
[2] Gaziantep Childrens Hosp, Dept Anesthesiol & Reanimat, Gaziantep, Turkey
[3] Gaziantep Univ, Sch Med, Dept Anesthesiol & Algol, Gaziantep, Turkey
[4] Sehitkamil Govt Hosp, Dept Anesthesiol & Reanimat, Gaziantep, Turkey
[5] Gaziantep Univ, Sch Med, Dept Clin Biochem, Gaziantep, Turkey
关键词
Pediatric; Tonsillectomy; Pre-emptive; Tramadol; Ropivacaine; CONTROLLED CLINICAL-TRIAL; DAY-CASE ADENOIDECTOMY; DAY-CASE SURGERY; POSTOPERATIVE PAIN; DOUBLE-BLIND; PERITONSILLAR INFILTRATION; CHILDREN; RELIEF; ADENOTONSILLECTOMY; BUPIVACAINE;
D O I
10.1016/j.ijporl.2012.01.031
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: To investigate the placebo controlled effect of pre-emptive local infiltration of ropivacaine and intravenous tramadol in postoperative pain and nausea-vomiting in pediatric tonsillectomy cases. Methods: 90 children at ASA I-II physical status, who are between 2 and 9 years old, underwent tonsillectomy were included to the study. Patients were randomized into one of three study groups. Group I was i.v. saline group (placebo group), Group II was preemptive 1.5 ml 0.75% ropivakain to the tonsil lodge and Group III was preemptive 1 mg/kg i.v. tramadol. Hemodynamic parameters and synchronized Maunuksela pain scores were evaluated in the post anesthetic care unit. Results: There was no difference in age, weight, sex and hemodynamic parameters of children included to the study groups. Postoperative nausea vomiting was significantly lower in Group II and pain scores at resting and swallowing are significantly lower than the other study groups. Maunuksela pain scores at 2nd, 3rd, 6th and 9th hours while resting were significantly lower in Group II compared with Groups I and III (p < 0.001). The comparison of scores between groups I and III were similar. Maunuksela pain scores during swallowing were significantly lower in Group II compared with Group land III at 2nd, 3rd, 6th, 9th, 12th, 21st and 24th hours postoperatively (p < 0.001). While comparing Maunuksela pain scores of Groups land III, significantly lower scores are determined at 2nd and 24th hours in Group Ill (p < 0.001). Analgesic needs were significantly low in Group II at postoperative period (150 +/- 30 mg paracetamol) (p < 0.05). It was similar in Groups I and III (Group I: 400 +/- 40 mg, Group III: 360 +/- 40 mg paracetamol). Conclusion: This study showed that peritonsillar ropivacaine infiltration might produce an effective postoperative analgesia probably due to a preventing effect on sensitization of the pain pathways. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:653 / 657
页数:5
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