Tonsillectomy Clinical Trial
Official title:
The Effect of Bupivacaine (Marcaine) in Reducing Early Post Tonsillectomy Pain
Research Methodology:
It will be a prospective, randomized, placebo-controlled, single-blind, intra-individual
study in which one tonsillar fossa will be the tested side, and the other fossa will be the
control. And the tested side will be packed with bupivacaine for five minutes. In the other
hand, the controlled side will be packed for five minutes with gauze soaked in normal
saline. The selection of the tested side and controlled side will be randomized based on the
last digit in the medical record number (i.e. if the last digit is even then the tested side
is the right and if the last digit is odd then the tested side is the left). Pain evaluation
will be by visual analog scale and it will be in frequency of 2, 4, 6, 8, 12, 24 hours
post-op.
Evaluation of The Effect of Bupivacaine (marcaine) in Reducing Early Post Tonsillectomy Pain
(Prospective, randomized, intra-individual study.) Study guidelines
Aim of the study
- to evaluate the effectiveness of applying bupivacaine intra-operative in reducing early
post-tonsillectomy pain
Patients and methods
- It will be a randomized, placebo-controlled, single-blinded study
- one tonsillar fossa will be the tested side, and the other fossa will be the control
- to insure the random selection, the tested and control sides will be selected based on
unpredicted method e.g. based on the last number in pt MRN: If the last # is even (0,
2, 4, 6, 8) = right side will be the tested If the last # is odd (1, 3, 5, 7, 9) = left
side will be the tested
- Exclusion criteria included :
1. pt with past history of unilateral peritonsillar abscess
2. the current, regular use of a systemic steroid or NSAID
3. a known hypersensitivity to bupivacaine
4. a combined with unilateral myringotomy or bilateral myringotomy with unilateral
ventilation tube
5. pt with poor dental hygiene
- accompanied adenoidectomy is not an exclusion criteria
- the tested side will be : packed (after classic tonsillectomy) with gauze soaked in
0.5% bupivacaine, (2ml of bupivacaine + 2ml NS)for 5 min.
- the control side will undergoing the same of tested side but with normal saline
- post-operative analgesia will be paracetamol
- pain evaluation will be by visual analog scale (fig. 1) and it will be in frequency of
2, 4, 6, 8, 12, 24 hours post-op (frequency can be re-adjusted)
- Data of pain will be collected by the nurse. And they will not know which side is the
tested. (single- blind)
- after phase I (data collection). Data will be calculated for P-value and other
statistics scores
- Targeted sample size is 35 patients.
- patients will be consented for the possible adverse reactions of local application of
the tested medicine (e.g. allergic reactions, Paresthesia). However, because in our
study we will not add adrenaline, so differences in incidence of post-tonsillectomy
bleeding is not expected.
- data will be statistically analyzed by McNemar's test
- For the data safety monitoring of the study, an independent external otolaryngology
consultant (Dr.Ahmed Alarfij) will be assigned to monitor the safety of study
participants.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Masking: Single Blind (Subject), Primary Purpose: Supportive Care
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