Comparative study of 0.5% bupivacaine infiltration versus sterile water infiltration in tonsillar fossa during tonsillectomy performed under general anaesthesia

Santosh U. P., Sanjay V. C.


Background: Tonsillectomy is a treatment of choice when medical line treatment is failed in chronic tonsillitis. Post tonsillectomy pain is the most common problem of this surgery which may persists for weeks and affect normal daily activities. Use of opiods and non-steroidal anti-inflammatory drugs for relieving pain may leads to nausea, vomiting and post tonsillectomy haemorrhages. We renewed interest in infiltration of local anaesthetic drug in the tonsillar fossa during tonsillectomy. To evaluate the efficacy of 0.5% bupivacaine infiltration in tonsillar fossa during tonsillectomy under general anaesthesia in terms of post-operative pain relief.

Methods: It is double blinded prospective comparative study was carried out on 100 patients of either sex and age 5-40 years who diagnosed with chronic tonsillitis undergoing tonsillectomy and willing to participate in study were included.50 patients were infiltrated with sterile water and other 50 patients were infiltrated with 0.5% bupivacaine in the tonsillar fossa during tonsillectomy performed under general anaesthesia. Postoperatively at 2nd, 6th, 24th hours and 7th day all patients were evaluated for pain score by using visual analogue scale.  

Results: In our study, post-operative pain mean score 2nd, 6th, 24th hour and 7th day post-operative period for test and control group was “3.3 and 7.1”, “3.2 and 5.2”, “1.7 and 4.8” and “0.6 and 2.2” respectively which was found to be statistically significant (p<0.001).

Conclusions: 0.5% bupivacaine infiltration in the tonsillar fossa during tonsillectomy had lower pain score in post-operative period compare to sterile water infiltration.



0.5% bupivacaine, Sterile water, Tonsillectomy, Post-operative pain relief

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Rajput SD, Patel AV, Prajapati MB, Padavi DS. Role of Preincisional Peritonsillar Infiltration of Bupivacaine in Postoperative Pain Relief in Tonsillectomy Patients. Indian J Otolaryngol Head Neck Surg. 2019;71(1):610-3.

Mozafarinia K, Amizadeh M. Evaluation of local injection of 0.5% Bupivacaine and 1/200000 Epinephrine for Post tonsillectomy Pain reduction. American J Pharma Toxicol. 2007;2(2):26-7.

Bhadoria P, Rathore PK, Mandal S, Sehgal R, Meher R, Singh R. Evaluation of the duration of postoperative pain control obtained with bupivacaine injection into the tonsillar region in children who underwent tonsillectomy. 2006;58(4):335-6.

Somdas MA. Efficacy of bupivacaine for post-tonsillectomy pain: a study with the intra-individual design. Int J Pediatr Otorhinolaryngol. 2004;68(1):1391-5.

Meena SK, Jain R, Meena VK, Meena R, Meena M. Control of post-operative pain by pre- tonsillectomy peritonsillar infiltration. J Evol Med Dental Sci. 2015;4(69).

Sharifian HA, Fathololoomi MR, Bafghi AF, Naini SAS. Department of ENT, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences and Health Services. TEHRAN-IRAN. 2006;5(1):45-9.

Ihvan O, Seneldir L, Enoz M, Gokceer T, Koksal S, Ihvan O, et al. Department of Anesthesiology, 1st Affiliated Hospital, Wenzhou Medical College, Wenzhou, China. Kulak Burun Bogaz Ihtis Derg. 2011;21(5):270-5.

Garcia AMV, Fragoso SB, Pazos CJ, Moreno AG, Gil LMT, Mon GF. Intraoperative infiltration of 0.5% Bupivacaine in pediatric tonsillectomy. Acta Otorrinolaringol Esp.1997;48(4):287-90.

Wong AK, Bissonnette B, Braude BM, Macdonald RM, Louis SPJ, Fear DW. Post-tonsillectomy infiltration with bupivacaine reduces immediate postoperative pain in children. Can J Anaesth. 1995;42(9):770-4.

Post-tonsillectomy infiltration with bupivacaine reduces immediate postoperative pain in children. Can J Anaesth. 1995;42(9):770-4.