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Korean Journal of Anesthesiology 2003;44(6):820-827.
DOI: https://doi.org/10.4097/kjae.2003.44.6.820   
The Effect of Lesser Palatine Nerve Block on Pain after Elective Pediatric Tonsillectomy.
Hyo Jung Kim, Sun Ok Song, Chang Hoon Lee, Yoon Suk Son, Il Sook Seo, Sae Yeon Kim
1Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea. sosong@med.yu.ac.kr
2Department of Anesthesiology and Pain Medicine, Eulji University College of Medicine, Daejeon, Korea.
3Department of Otolaryngology and Head and Neck Surgery, Eulji University College of Medicine, Daejeon, Korea.
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.
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.
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.
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.
Key Words: Lesser palatine nerve block; pediatric tonsillectomy; preemptive analgesia; postoperative pain


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