2004, Number 1
<< Back Next >>
Rev Med Inst Mex Seguro Soc 2004; 42 (1)
Preventive analgesia in adenotonsillectomy
Carrillo CA, Corbalá FC, Pacheco UA, Tapia LJ, Medina FV, Haro GL
Language: Spanish
References: 18
Page: 55-59
PDF size: 63.99 Kb.
ABSTRACT
Objective: our objective was to evaluate effectiveness of preemptive analgesia in child patients
with adenotonsillectomy.
Materials and methods: design was a controlled
clinical trial carried out at the Zone 3 General
Hospital in Mazatlan, Sinaloa. Population was
pediatrics patients of 3 to 12 years of age programmed
for selective adenotonsillectomy.
We standardized surgical technique and 70 patients
were assigned in random form into two
groups. In group I, we infiltrated plain lidocaine 2 %
in peritonsillar area before surgery; group II was
without lidocaine. The following variables were
registered: age, sex, surgical time, cardiovascular
effects during surgery, postoperative emergency,
and clinical evaluation before and after
surgery. We used descriptive statistics, and the
table of 2 x 2 for qualitative variables.
Results: 67 % of patients were female; 78 % of
patients were between the ages of 3 and 5 years.
There were no differences as far as results of
universal variables and surgical time. Patients of
group I had behavior stability in 67 % (n = 23)
against 23 % (n = 8) of group II, with a value of p
‹ 0.0001. As far as calm anesthetic emersion,
we observed this in 69 % of group 1 (n = 24) and
in 26 % (n = 9) in group 2, with a value of p ‹
0.0001.
Conclusions: the study showed effectiveness of
previous anesthetics in pediatric patients with
adenotonsillectomy when having better hemodynamic
stability. Also, we observed lesser consumption
of medications, which probably reduces
costs of this surgery.
REFERENCES
Egan KJ. Psychological signs in posoperative pain. Anesthesiol Clin North Am 1989;7:183-192.
Giannon CM, White S, Enue King JF, et al. Bupivacaine with or without clonidine improves pediatric tonsillectomy pain. Arch Otolaryngol Head Neck Surg 2001;127:1265-1270.
Coderre T, Katz J, Vaccarino A, Melzack. Contribution of central neuroplasticity of pathologycal pain. Review of clinical and experimental evidence. Pain 1993;52:256-285.
Rivera-Secchi A, Castorena-Arellano G. Analgesia posoperatoria. Revisión y conceptos actuales. Rev Mex Anest 1992;15:26-29.
Aldrete JA. Manual clínico del dolor. Segunda edición. México: JGH Editores; 2000. p. 1-10.
Boelen-Van-Der Loo WJ, Scheffer E, de-Haan RJ, et al. Clinimetric evaluation of pain observation scale for young children aged between 1 and 4 years after ear, nose and throat surgery. J Dev Pediatr 1999;20:222-227.
Ramírez-Guerrero A. Dolor agudo posoperatorio, su frecuencia y manejo. Rev Mex Anest 1992;15:14-17.
Gerber N, Apseloff GMD. Fatality after an injection of bicillin into tonsillar fossa during an adenotonsillectomy. Otolaryngol Head Neck Surg 2002;126: 321-322.
Infante-Ramírez MG. Eficacia de la analgesia previa. Anest Mex 1999;11(1):30-35.
Orntoft S. A comparison of pre and postoperative tonsillar infiltration with bupivacaine on pain after tonsillectomy. A preemptive effect? Anaesthesia 1994;94:151-154.
Giannoni C. White S. Does dexamethasone with preemptive analgesia improve pediatric tonsillectomy pain Otolaryngol Head Neck 2002;126:307-315.
Dahl JB, Kehlet H. The value of preemptive analgesia in the treatment of postoperative pain. Br J Anaesthesia 1993;70:434-449.
Johansen M, Harbo G, Illum P. Preincisional infiltration with bupivacaine in tonsillectomy. Arch Otolaryngol Head Neck Surg 1996;122(3):261-263.
Kountakis SE. Effectiveness of perioperative bupivacaine infiltration in tonsillectomy patients. Am J Otolaryngol 2002;23(2):76-80.
Stuart JC, McGregor FB. Peritonsillar infiltration with bupivacaine for pediatric tonsillectomy. Anaesth Intensive Care 1994;22(6):679-682.
Melchor MA, Villafruela NA. Postoperative pain in tonsillectomy in general anesthesia and local infiltration. Acta Otorrinolaringol Esp 1994;45(5): 349.
Molliex S, Haond P, Baylot D. Effect of preoperative versus postoperative tonsillar infiltration with local anesthetics on postoperative pain after tonsillectomy. Acta Anaesthesiol Scand 1996;40(10): 1210-1215.
Tyler DC, Krane ES. Postoperative pain management in children. Anesthesiol Clin North Am 1989; 7:155-170.
Full text