Effects of local injection of bupivacaine and dexamethasone on postoperative pain of adenotonsillectomy

Adenotonsillectomy is a common surgical operation which is frequently associated with complications such as pain, hemorrhage and laryngospasm. For reduction of the possibility of postoperative bleeding and agitation, pain control is important. The opioid drugs are now being used for pain control, but their inconvenient side effects such as apnea may worry physicians. Therefore, the aim of this study was to compare the effect of local application of bupivacaine and dexamethasone with that of placebo on postoperative pain of adenotonsillectomy. This double-blind and case-control study was performed on 90 patients subjected to tonsillectomy operation with 3-30 years old, during spring and summer of 2005 in Kashani hospital, Shahrekord, Iran. The patients were randomly divided into three equal groups of A, B and C. The individuals in group A (cases) received a local injection of 2 ml of 0.5% bupivacaine, group B received a local injection of and group C (control) received a local injection of 2 ml of normal saline. Six, 12 and 18 hours after the operation, using McGill questioners, pain intensity was evaluated. Data was analyzed using c2 test. Mean age was not significantly different among the 3 groups. 45.6% of the patients were male and the rest were female. Six hours after the operation, pain intensity in group received bupivacaine was more than that of in group received placebo (p<0.05). However, 12 and 18 hours after the operation there was no statistically significant difference in pain intensity among the groups. bupivacaine and dexamethason with dosage used in this study had no effect on pain intensity in these patients.