Comparison of the efficacy of ropivacaine and ropivacaine with dexmeditomidine in post tonsilectomy pain relief after peritonsillar infiltration- A prospective randomized double blind study

Abstract

Introduction: Post operative pain relief is desired goal after tonsillectomy, infiltration of local anesthetic with or without adjuvant can reduce post tonsillectomy pain. \nObjective: To compare the postoperative analgesic efficacy and side-effects of peritonsillar-infiltration of ropivacaine with or without dexmeditomidine. \nMaterials and Methods: Sixty patients aged 4-14 years posted for tonsillectomy under GA were randomly assigned in two groups of 30 each. In group R: Inj. ropivacaine (0.5%) 0.2ml/kg and in group RD: Inj.ropivacaine (0.5%) 0.2 ml/kg + Inj. dexmeditomidine 1mcg/kg were infiltrated in peritonsillar fossa post tonsillectomy. Patient were monitored for post-operative pain using VAS score, CHEOPS score and Wong baker pain rating scale at 30 minute, 1hr, 2hr, 4hr, 10 hr, 16hr and 24hr, pain on deglutination, time to first analgesic requirement, total dose of analgesics requirement in 24 hr postoperatively, amount of bleeding and parent’s satisfaction score. \nResults: VAS score, CHEOPS and Wong baker pain rating scale were comparable in both the groups at 30 min, 1hr, 2hr (P >0.05) but it was significantly low in group RD as compared to group R at 4hr, 10hr, 16hr and 24hr (P \nConclusion: We concluded, peritonsillar infiltration of ropivacaine with or without dexmeditomidine is effective method for post-tonsillectomy pain relief. Addition of dexmeditomidine was found to prolong duration, decrease analgesic requirement and improve parent’s satisfaction score. \n \nKeywords: Tonsillectomy, Visual analog score, CHEOPS, Wong baker pain rating scale, Ropivacaine and dexmeditomidine.