| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 9
| Issue : 4 | Page : 310-320 |
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Efficacy of peritonsillar infiltration of levobupivacaine-dexamethasone versus levobupivacaine-dexmedetomidine in children undergoing tonsillectomy surgery: a prospective, randomized double-blind study
Salwa M.S Hayes1, Hisham Atef Ebada2, Hanaa M El Bendary1
1 Department of Anesthesia and Intensive Caer, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Department of Oto-Rhino-Laryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Correspondence Address:
MD Salwa M.S Hayes
Department of Anesthesia and Intensive Care, Faculty of Medicine, Mansoura University, Mansoura
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/roaic.roaic_36_22
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Purpose We evaluated the quality of analgesia produced by peritonsillar infiltration of levobupivacaine with either dexamethasone or dexmedetomidine in children undergoing tonsillectomy surgery.
Patients and methods Patients scheduled for tonsillectomy were randomly allocated into three groups with 27 patients in each group. Group L received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine, while group D received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine mixed with dexamethasone 0.5 mg/kg and group X received peritonsillar infiltration of 5 ml in volume of 0.4 mg/kg of 0.5% levobupivacaine mixed with dexmedetomidine 1 μg/kg (with infiltration of 2.5 ml in each tonsil in all groups) with the first postoperative analgesic request as the primary outcome.
Results Postoperative time to first analgesic paracetamol request was prolonged in group D (19.51±2.34 h) compared with group L (4.15±0.53 h) and group X (15.74±2.29 h). Face, leg, activity, cry, consolability (FLACC) Behavioral Pain Assessment score at rest and during swallowing decreased in group D compared with group L and group X. Total postoperative analgesic consumption decreased in group D (581.48±165.7 mg) compared with group L (1303.51±90.10 mg) and group X (680.50±160.67 mg).
Conclusions We concluded that peritonsillar infiltration of levobupivacaine when mixed with either dexamethasone or dexmedetomidine for patients undergoing tonsillectomy produced prolonged analgesia; however, dexamethasone was superior to dexmedetomidine with more prolonged time to first paracetamol request and prolonged late postoperative pain relief.
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