Turk Anesteziyoloji ve Reanimasyon, cilt.30, sa.10, ss.463-467, 2002 (Scopus)
The aim of our study was to investigate the effect of peritonsiller bupivacaine infiltration on postoperative pain and agitation. Fourty children of ASA class I, aged between 3-6 years, who were scheduled for elective adenotonsillectomy were randomized into two groups. Anaesthesia was induced with 8% sevoflurane in 60/40% N2O/O2 and maintained with % 2-3 sevoflurane in both groups. Before the surgical procedures, Group I (n=20) patients received peritonsillar infiltration of 0.25% bupivacaine 0.5 mL/kg and Group II (n=20) patients received 0.9 % saline 0.5 mL/kg to a maximum of 10 mL. In per and postoperative period, heart rates (HR), sistolic (SAP) and diastolic arterial pressures (DAP) were monitorized for one hour and observed for six hours. Patients were assessed by giving a pain score from 1 to 3 and agitation score from 1 to 4. If a child scored 3 or 4, it was judged to be in severe agitation. Analgesic re-quirement, agitation and vomiting comparisons were done in both groups. Between the intraoperative 10th minutes and postoperative 30th minutes, the heart rates of Group I patients were significantly lower when compared with Group II. Although there were no significant alterations from baseline in Group I, it was significantly high in Group II after extubation. Agitation and vomiting incidances were similar in postoperative period. There were no significant differences in pain scores except the first 10 min period. Analgesic requirements were significantly lower in Group I in postoperative 6 hours period. We conclude that peritonsillar bupivacaine infiltration is effective on early postoperative analgesia, but it dose not markedly change the incidance and severity of agitation.