Nitin B, Gupta Manish
Department of ENT and Head Neck Surgery, Maharishi Markandeshwar College of Medical Sciences and Research, Ambala, Haryana India.
Department of ENT and Head Neck Surgery, Gian Sagar Hospital and Medical College, Banur Rajpura, Punjab India.
Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1805-1818. doi: 10.1007/s12070-023-04417-6. Epub 2023 Dec 23.
Tonsillectomy is one of the most common surgical procedures practiced in Otorhinolaryngology. A significant obstacle for the speedy and smooth recovery is early post- operative pain. Pain leads to negative outcomes such as poor intake, tachycardia, anxiety, delayed wound healing and insomnia. Aim to assess and compare the effect of post-incisional infiltration of 0.75% Ropivacaine v/s 0.5% Bupivacaine on post tonsillectomy pain, the on start of oral intake and stay in hospital and to investigate any complications that can arise due to infiltration of the said drugs. 60 Patients above the age of 5 years were posted for tonsillectomy or adenotonsillectomy under general anesthesia. Patients were blinded about the group in which they will be enrolled. Group A received Inj. ropivacaine (0.75%) 2 ml and Group B: received Inj. Bupivacaine (0.50%) 2 ml in each fossa. After surgery, no analgesics were given & patients were observed for the intensity of post-operative pain in the immediate post-operative period, at 2, 4, 6, 12, 24, 48 h and further if not discharged using VISUAL ANALOGUE SCORE (VAS) and VERBAL RATING SCALE(VRS). Post-operative pain assessment was done using VAS and VRS at 2nd, 4th, 6th, 12th, 24th and 48th hour which was found to be lower in Group 'A'. Patients in Group 'A' also started their oral intake sooner, had lesser hospitalization days than group 'B' patients. Longer time for Rescue analgesic and reduced total dose of analgesic required was seen in Group A compared to Group B. This comparative study on Post-incisional infiltration of 2 ml 0.75% Ropivacaine v/s 2 ml 0.5% Bupivacaine has shown that Ropivacaine is a more effective drug in reducing post-operative pain in comparison to Bupivacaine, proven statistically.
扁桃体切除术是耳鼻喉科最常见的外科手术之一。术后早期疼痛是快速顺利康复的一个重大障碍。疼痛会导致诸如摄入不足、心动过速、焦虑、伤口愈合延迟和失眠等负面结果。目的是评估和比较0.75%罗哌卡因与0.5%布比卡因切口浸润对扁桃体切除术后疼痛、开始经口进食时间和住院时间的影响，并调查因上述药物浸润可能出现的任何并发症。60名5岁以上患者在全身麻醉下接受扁桃体切除术或腺样体扁桃体切除术。患者对自己将被纳入的组别不知情。A组在每个窝内注射2毫升0.75%罗哌卡因注射液，B组在每个窝内注射2毫升0.5%布比卡因注射液。手术后，未给予镇痛剂，并使用视觉模拟评分法（VAS）和语言评定量表（VRS）在术后即刻、2、4、6、12、24、48小时以及若未出院则进一步观察患者术后疼痛强度。在第2、4、6、12、24和48小时使用VAS和VRS进行术后疼痛评估，发现“A组”疼痛程度较低。“A组”患者也更早开始经口进食，住院天数比“B组”患者少。与“B组”相比，“A组”患者使用补救镇痛剂的时间更长，所需镇痛剂的总剂量减少。这项关于2毫升0.75%罗哌卡因与2毫升0.5%布比卡因切口浸润的对比研究表明，与布比卡因相比，罗哌卡因在减轻术后疼痛方面是一种更有效的药物，经统计学验证。
