Comparison of the effect of peritonsillar infiltration of tramadol vs dexmedetomidine on post-tonsillectomy pain

• Published in: European archives of oto-rhino-laryngology Vol. 279; no. 5; pp. 2665 - 2669
• Main Authors: Hatami, Maryam, Jalali, Mohsen, Ayatollahi, Vida, Baradaranfar, Mohammadhossein, Vaziribozorg, Sedighe
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2022
• Subjects: Analgesics, Opioid - therapeutic use; Child; Child, Preschool; Dexmedetomidine - therapeutic use; Double-Blind Method; Head and Neck; Head and Neck Surgery; Humans; Medicine; Medicine & Public Health; Neurosurgery; Otorhinolaryngology; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Tonsillectomy; Tramadol - therapeutic use; Post-tonsillectomy pain; Tramadol; Dexmedetomidine
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-021-07102-y

Introduction
This study aimed to comparing the effect of peritonsillar infiltration of tramadol and dexmedetomidine in relieving post-tonsillectomy pain.
Methods
In this randomized double blinded clinical trial study, 90 children 5–12 years old undergoing tonsillectomy, involved. Induction of anesthesia was done by fentanyl 1 µg/kg, sodium thiopental 5 mg/kg and atracurium 0.5 mg/kg and intubation was done after 3 min. Anesthesia maintained by nitrous oxide 60% and oxygen 40% with isoflurane (1.2%). Tramadol 2 mg/kg in group A, dexmedetomidine 1 µg/kg in group B, and normal saline in group c were injected into the bed and anterior tonsillar pillar and surgery has begun after 3 min of injection. Time of surgery, all hemodynamic variables, pain intensity and degree of sedation were recorded and evaluated.
Results
The results showed that duration of the surgery (
p
value = 0.28) and duration of anesthesia (
p
value = 0.43) were not significantly different between the groups but pain score was significantly lower in dexmedetomidine group in comparison to tramadol and placebo group (
p
value = 0.001). The first time for analgesic request was longer in dexmedetomidine group (
p
value = 0.001) and Hemodynamic parameters were significantly lower in tramadol and dexmedetomidine group (
p
value = 0.001). Sedation level was not significantly different between tramadol and dexmedetomidine group (
p
value = 0.001).
Conclusion
According to the results peritonsillar infiltration of dexmedetomidine is effective and safe in relieving post-tonsillectomy pain.