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

Lee, Chang Hoon; Park, Kyung You; Lee, Jae Soo; Chang, Dong Sik; Choi, Myung Su; So, Yoon Mi

Abstract

BACKGROUND AND OBJECTIVES: This prospective, randomized double-blind study was performed to evaluate the analgesic effect of lesser palatine nerve block after pediatric tonsillectomy, and we measured analgesic efficacy and degree of blocks induced by ropivacaine.
SUBJECTS AND METHOD
Children who weighed 20-40 kg and scheduled for an elective tonsillectomy were randomized into three groups. Patients received lesser palatine nerve block, using divided doses of 0.05 ml/kg of 0.2% ropivacaine (Naropin registered), 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 blocks. Postoperative pain was measured immediately after surgery and at 3, 6, 12 and 24 hours following the operation by using a 0 to 4 points pain scale, based on a facial expression of pain scale ruler. Side effects and the number of analgesic inductions 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 group (p>0.05). The number of analgesic injections were similar in the groups.
CONCLUSION
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.