Korean J Anesthesiol.  2003 Jun;44(6):820-827. 10.4097/kjae.2003.44.6.820.

The Effect of Lesser Palatine Nerve Block on Pain after Elective Pediatric Tonsillectomy

• Kim HJ
• Song SO
• Lee CH
• Son YS
• Seo IS
• Kim SY

• KMID: 2239958
• DOI: http://doi.org/10.4097/kjae.2003.44.6.820

Abstract

BACKGROUND: This prospective, double-blind randomized study was performed to evaluate the analgesic effect of lesser palatine nerve block for postoperative pain control after a pediatric tonsillectomy, and to compare the analgesic effects of pre-emptive versus postoperative blocks.
METHODS
Forty-eight ASA class 1 children, scheduled for an elective tonsillectomy were randomized into three groups. Patients received lesser palatine nerve blocks, using divided doses of 0.05 ml/kg of 0.2% ropivacaine, 5 min prior to the beginning of tonsillectomy (Pre-block group) or immediately after surgery (Post-block group). Patients allocated into the Control group did not receive any nerve block. Postoperative pain was measured immediately after surgery, 3, 6, 12 and 24 hours following operation using a 0 to 4 points pain scale, based on a facial expression of pain scale ruler. Side effects and the number of analgesic injections were observed for 24 hours postoperatively.
RESULTS
No significant differences in the pain scores were observed immediately after surgery and at 3, 6, 12 and 24 hours after operation in the three groups (P > 0.05). The number of analgesic injections was similar in the groups.
CONCLUSIONS
The results of this study reveal that the lesser palatine nerve block was not effective for postoperative pain control following pediatric tonsillectomy, and that the pre-emptive block offered no pain control benefit over the postoperative block. Therefore, we do not recommend lesser palatine nerve blocks for the management of postoperative pain after pediatric tonsillectomy.

Keyword

Lesser palatine nerve block; pediatric tonsillectomy; preemptive analgesia; postoperative pain

MeSH Terms

Child
Facial Expression
Humans
Nerve Block*
Pain, Postoperative
Prospective Studies
Tonsillectomy*