Department of Otolaryngology, Uludag University Medical School, 16059 Gorukle, Nilufer-Bursa, Turkey.
Eur Arch Otorhinolaryngol. 2013 Feb;270(2):761-6. doi: 10.1007/s00405-012-2194-1. Epub 2012 Sep 30.
The aim of this prospective single-blinded and controlled study is to evaluate the efficacy of levobupivacaine infiltration on post-tonsillectomy pain relief in adults. The study was conducted with 40 adult patients who underwent tonsillectomy. These patients were randomized in either study group (SG) who received levobupivacaine infiltration to peritonsillary fossae prior to surgery or control group (CG) with no medication. After surgery, all the patients were queried for pain scores by visual analog scale. In addition, the volume of intraoperative bleeding, the duration of operation, the severity of postoperative complications, and the amount of analgesic requirement were the other outcome measures of this study. There were significant differences between groups regarding pain scores for the first 24 h in favor of SG. The analgesic requirement was also significantly lower in SG (p = 0.009). Although there was a sustained decrement at pain score during first 24 h for SG, however, the change from baseline score (immediate score) for each time interval revealed no significance compared to CG. In addition, the duration of operation and the volume of intraoperative bleeding were similar (p = 0.64 and p = 0.165). In conclusion, preincisional infiltration of levobupivacaine is a safe and reliable method for post-tonsillectomy pain reduction in adults. However, more in-depth, double-blinded and placebo controlled studies are required to elucidate its long term benefits.
本前瞻性单盲对照研究旨在评估浸润左旋布比卡因在成人扁桃体切除术后疼痛缓解中的疗效。研究纳入了 40 名接受扁桃体切除术的成年患者。这些患者随机分为研究组（SG），即在手术前将左旋布比卡因浸润到扁桃体窝周围；或对照组（CG），不给予任何药物。手术后，所有患者均通过视觉模拟评分法（VAS）评估疼痛评分。此外，术中出血量、手术时间、术后并发症严重程度和镇痛需求的量是本研究的其他结果指标。SG 组在术后 24 小时内的疼痛评分明显低于 CG 组。SG 组的镇痛需求也明显低于 CG 组（p = 0.009）。尽管 SG 组在术后 24 小时内的疼痛评分持续下降，但与 CG 组相比，每个时间间隔的基线评分（即刻评分）的变化没有统计学意义。此外，手术时间和术中出血量相似（p = 0.64 和 p = 0.165）。总之，术前浸润左旋布比卡因是一种安全有效的减轻成人扁桃体切除术后疼痛的方法。然而，需要更深入、双盲和安慰剂对照的研究来阐明其长期益处。
