Evaluation of the effect of Bupivacaine (Marcaine) in reducing early post tonsillectomy pain

OBJECTIVE: To evaluate the effectiveness of bupivacaine as topically applied in reducing post tonsillectomy pain within the first 24 hours.

METHODS: This prospective, randomized, placebo-controlled, intra-individual, single-blind study was conducted at the Otolaryngology Department, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia from October 2009 until March 2010. Thirty-five patients underwent cold knife tonsillectomy. One tonsillar fossa was packed with gauze soaked in plain 0.25% bupivacaine, while the other tonsillar fossa was packed with gauze soaked in normal saline (the control side). Both gauzes were applied for 5 minutes. The patients' pain was evaluated on each side using the visual analog scale at 2, 4, 6, 12, and 24 hours post-operatively.

RESULTS: The reduction in pain at 2 and 4 hours was statistically insignificant compared with the control side. However, at 6, 12, and 24 hours post operatively, the reduction of pain was statistically significant.

CONCLUSION: Topical application of bupivacaine at a 0.25% concentration appears to a considerable degree of analgesia within the first 24 hours post tonsillectomy.