INCLUSION OF PETHIDINE IN LIDOCAINE FOR INFILTRATION IMPROVES ANALGESIA FOLLOWING TONSILLECTOMY IN CHILDREN

Background: Previous work has demonstrated that pethidine exerts local anaesthetic effects on peripheral nerves in vivo. We examined the eff ects of infiltration anaesthesia by a combination of pethidine and lid ocaine on post tonsillectomy pain and restlessness in children. Method s: Eighty children were randomly allocated to receive peritonsillar in filtration postoperatively with 3 mi of lidocaine 2% (1.5 mi on each s ide) combined with either 0.1 mi pethidine, 10 mg . mi(-1), (pethidine group) or 0.1 mi normal saline (control group). Pain and behaviour we re assessed at 1, 3, 6 and 12 h postoperatively and on the following m orning by the patients and by a nurse blinded to previous treatment. R esults: Patients in the pethidine group had lower pain scores than tho se in the control group at rest as well as swallowing during the whole observation period (P<0.05). Paracetamol was given to 34/40 children in the control group and to 6/40 children in the pethidine group. The corresponding figures for pethidine administration were 6/40 and 0/40, respectively. Patients in the pethidine group displayed a more rapid return to calm wakefulness than those in the control group (P<0.01). C onclusion: Inclusion pf a low dose of pethidine in lidocaine for tonsi llar infiltration improves pain relief after tonsillectomy in children . (C) Acta Anaesthesiological Scandinavica 41 (1997).