The Effect of Lidocaine-Epinephrine Administration in Controlling Complications after Tonsillectomy

Tonsillectomy is one of the most common surgeries in children, which is associated with pain and bleeding after the operation. This study was conducted to investigate the effect of lidocaine-epinephrine administration in controlling complications after tonsillectomy.

This clinical trial was conducted on 109 patients aged 5 to 18, who had referred to Kowsar Hospital in Sanandaj for tonsillectomy. After dividing the patients randomly, 40 mg of 1% lidocaine and 5 μg of epinephrine (a volume of 5 ml) were injected into the tonsillar bed in the intervention group before the surgery, but in the patients of the control group, surgery was started without lidocaine-epinephrine administration. Blood pressure and heart rate of the patients before, during and after surgery, and pain intensity based on Wong-Baker Faces Pain Scale at minutes 30 and 60 and 6, 12 and 24 hours after surgery, and the amount of bleeding during and after surgery were recorded and compared by calculating the volume of suction and blood pads as well as the length of stay in recovery.

The mean amount of bleeding in the intervention group was 65.5±47.1 ml and in the control group was 113.7±45.7 ml (p=0.0001). The mean pain intensity and hemodynamic changes at minutes 30 and 60, and 6, 12 and 24 hours after surgery in the intervention group were lower than the control group and showed statistically significant differences (p=0.0001). The mean time of discharge from recovery in the intervention group was 0.35±23.2 minutes and in the control group was 50.4±17.5 minutes (p=0.0001).

Based on the results of this study, it seems that the administration of lidocaine-epinephrine in the tonsil bed before tonsillectomy can reduce the amount of pain, bleeding, and hemodynamic changes during and after surgery, and the patient can recover sooner.