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VOLUME 14 , ISSUE 3 ( September-December, 2022 ) > List of Articles


To Study the Effect of Pre-incisional Infiltration of Ropivacaine for Post-tonsillectomy Pain Relief

Aastha Bhatnagar, Anuja V Satav, James Thomas, Srinithya Kancherla, Shubhangi Prasad, Rajesh Pareek, Lakshmisravya Kakollu, Rishikesh Pawar

Keywords : Local anesthetic, Pain, Pre-incisional infiltration, Ropivacaine, Tonsillectomy

Citation Information : Bhatnagar A, Satav AV, Thomas J, Kancherla S, Prasad S, Pareek R, Kakollu L, Pawar R. To Study the Effect of Pre-incisional Infiltration of Ropivacaine for Post-tonsillectomy Pain Relief. Int J Otorhinolaryngol Clin 2022; 14 (3):79-81.

DOI: 10.5005/jp-journals-10003-1409

License: CC BY-NC 4.0

Published Online: 20-03-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: To assess the effect of pre-incisional peritonsillar infiltration of ropivacaine on severity of pain after tonsillectomy. Background: Ropivacaine is a local anesthetic drug that has recently been gaining popularity. It is a synthetic drug of long-acting, amide type. It has a high protein-binding capacity of 90–95% that results in a longer duration of action of 6–8 hours. The onset of action, however, is delayed due to a lower lipid solubility as compared to lidocaine. When compared to bupivacaine, ropivacaine is relatively less cardiotoxic, thereby gaining popularity as an agent for epidural analgesia in gynecological procedures and for motor or sensory blocks in orthopedic surgeries. While the contribution of ropivacaine in treatment of pain that occurs after tonsillectomy has been evaluated, the reports are inconsistent, with respect to clinical trials that include lesser number of patients, and the conclusions have been disputable. Therefore, the study was conducted to assess the efficacy of ropivacaine in the management of post-tonsillectomy pain. Materials and methods: Patients were divided into two groups: Group “R”—administered 0.2 mL/kg of 0.75% ropivacaine hydrochloride infiltration into each peritonsillar fossa under general anesthesia but before tonsillectomy, and Group “S”—not administered anything in peritonsillar fossa under general anesthesia before tonsillectomy. Postoperative pain was assessed using a simple descriptive pain scale as subjective indicator for severity of pain. Results: Mild, moderate, and severe pain was reported among 84%, 16%, and 0%, respectively, with ropivacaine infiltration and 32%, 28%, and 40%, respectively, without ropivacaine infiltration. When severity of pain was compared among subjects with and without ropivacaine infiltration using, it was found to be statistically significant as p <0.05. Conclusion: Infiltration of 0.75% of ropivacaine pre-incisionally into the tonsillar bed is an effective measure to manage the postoperative pain in patients undergoing tonsillectomy. Clinical significance: Ropivacaine is an upcoming cardio-safe drug that has a very high threshold to achieve toxicity levels. It significantly helps to reduce immediate postoperative pain following any procedure and pain is one of the main factors causing morbidity in a procedure like tonsillectomy. Thus, there is the need for a research in the field.

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