Evaluation of the effect of Bupivacaine (Marcaine) in reducing early post tonsillectomy pain.

OBJECTIVE To evaluate the effectiveness of bupivacaine as topically applied in reducing post tonsillectomy pain within the first 24 hours. METHODS This prospective, randomized, placebo-controlled, intra-individual, single-blind study was conducted at the Otolaryngology Department, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia from October 2009 until March 2010. Thirty-five patients underwent cold knife tonsillectomy. One tonsillar fossa was packed with gauze soaked in plain 0.25% bupivacaine, while the other tonsillar fossa was packed with gauze soaked in normal saline (the control side). Both gauzes were applied for 5 minutes. The patients' pain was evaluated on each side using the visual analog scale at 2, 4, 6, 12, and 24 hours post-operatively. RESULTS The reduction in pain at 2 and 4 hours was statistically insignificant compared with the control side. However, at 6, 12, and 24 hours post operatively, the reduction of pain was statistically significant. CONCLUSION Topical application of bupivacaine at a 0.25% concentration appears to a considerable degree of analgesia within the first 24 hours post tonsillectomy.