A randomised controlled trial of the effect of regional nerve blocks on immediate post-tonsillectomy pain in adult patients

Post-operative pain is the main cause of morbidity following tonsillectomy. The efficacy of glossopharyngeal and lesser palatine nerve blocks in contr olling postoperative pain in adult patients was investigated prospectively. Patients 16 years and older admitted for elective tonsillectomy were rando mised to one of three groups to receive a pre-incisional oropharyngeal inje ction of 0.5% bupivicaine, a 'dummy' injection of saline or no injection. D issection tonsillectomy and general anaesthetic techniques were standardize d. Postoperative pain was monitored for 24 h. ANOVA, chi (2) and Fisher's e xact test were used for intergroup comparisons. Ninety-two patients (72 wom en and 20 men), mean age 22 years were studied. Twenty-nine patients receiv ed 0.5% bupivicaine, 30 saline and 33 no pre-incisional injection. The over all mean pain scores of 2.1, 1.9 and 1.9 in the bupivicaine, saline and no injection groups were similar. Glossopharyngeal and lesser palatine 0.5% bu pivicaine nerve blocks are not effective in reducing early post-tonsillecto my pain.