Ginström Robert, Silvola Juha, Saarnivaara Laila
Department of Otorhinolaryngology--Head & Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Acta Otolaryngol. 2005 Sep;125(9):972-5. doi: 10.1080/00016480510043413.
Use of a solution of bupivacaine (5 mg/ml)-epinephrine (5 microg/ml) (BE) is beneficial in reducing intraoperative bleeding and decreasing the operation time in adult (adeno)tonsillectomy patients.
Pain and intra- and postoperative bleeding are problems associated with tonsillectomy/adenotonsillectomy. In order to make tonsillectomy/adenotonsillectomy better suited to outpatient surgery, solutions to these problems should be found. One possibility may be the combination of local and general anesthesia. The aim of this study was to find out if such a combination is beneficial in tonsillectomy/adenotonsillectomy.
We performed a prospective, randomized, double-blind, controlled study on 64 adult (adeno)tonsillectomy patients to investigate the possible benefits of infiltrating the peritonsillar space with a BE solution.
In the recovery room, the BE group experienced less pain than a control group infiltrated with saline; subsequently there was no significant difference between the groups concerning pain. The average volume of intraoperative bleeding and the operation time were significantly smaller in the BE group. Postoperative bleeding from the tonsillar fossae occurred in 19% (6/31) of the patients in the BE group and in 18% (6/33) in the saline group.
使用布比卡因（5毫克/毫升）-肾上腺素（5微克/毫升）溶液（BE）有助于减少成人（腺样体）扁桃体切除患者的术中出血并缩短手术时间。
疼痛以及术中和术后出血是扁桃体切除/腺样体扁桃体切除相关的问题。为使扁桃体切除/腺样体扁桃体切除更适合门诊手术，应找到解决这些问题的方法。一种可能性或许是局部麻醉与全身麻醉相结合。本研究的目的是探究这种联合麻醉在扁桃体切除/腺样体扁桃体切除中是否有益。
我们对64例成人（腺样体）扁桃体切除患者进行了一项前瞻性、随机、双盲、对照研究，以调查用BE溶液浸润扁桃体周围间隙的潜在益处。
在恢复室中，BE组的疼痛程度低于用生理盐水浸润的对照组；随后两组在疼痛方面无显著差异。BE组的术中平均出血量和手术时间明显更短。BE组19%（6/31）的患者扁桃体窝出现术后出血，生理盐水组为18%（6/33）。
