Comparison of Peritonsillar Infiltration of Lidocaine and Bupivacaine for Management of Postoperative Pain of Tonsillectomy

Background: Postoperative pain following tonsillectomy is a common problem of this surgical procedure. Purpose: To compare the effects of preincisional peritonsillar infiltration of lidocaine and bupivacaine on post tonsillectomy pain in patients older than 8 years old. Methods: A double blind randomized clinical trial was conducted in patients undergoing elective tonsillectomy or adenotonsillectomy. The patients randomly allocated into three groups. Peritonsillar infiltrations with bupivacaine, lidocaine and normal saline were applied in group 1 2 and 3respectively. In 5th, 10th and 20th postoperative hours, the severity of pain was evaluated by visual analogue scale (VAS). Results: The patients in the bupivacaine group experienced a significantly milder pain in all postoperative hours comparing with the other groups. This effect was more obvious in male sex. The difference in pain sensation between lidocaine and saline groups was not significant. Conclusion: Peritonsillar infiltration of bupivacaine decreases pain in the first post-operative day after tonsillectomy whereas lidocaine does not show a similar effect.