Opioid Free Ptyregopalatine Ganglion Block Based Multimodal Anesthesia Versus Conventional Opioid Based Multimodal Anesthesia for Tonsillectomy Operations: A Randomized Controlled Trial
Abstract
Background Otolaryngology often involves adenotonsillectomies, surgical procedures aimed at addressing obstructive sleep-disordered breathing and underlying apnea in children. Objectives Pediatric anesthesiologists and otolaryngologists encounter challenges in managing pain post-adenotonsillectomy, especially due to the use of opioid medications in children who have an elevated baseline risk of airway obstruction and associated morbidity and mortality. Methods This prospective, randomized, double-blinded study was conducted at Eldemerdash Hospital, Ain Shams University, Egypt, from September 2022 to August 2023. A total of 90 patients aged 5 - 13 years who underwent elective tonsillectomy surgery were randomly assigned to two groups, with 45 patients in each group. The first group, referred to as group A, received intravenous 1.0 μg/kg fentanyl, dexamethasone 150 μg/kg, and paracetamol 15 mg/kg. The second group, referred to as group B, received dexamethasone 150 μg/kg and paracetamol 15 mg/kg, with an opioid-free pterygopalatine ganglion block for multimodal anesthesia. The primary outcome measure of this study was the postoperative Wong-Baker scale at 1st, 3rd, and 24th hours. Results This study included 90 individuals with similar demographic profiles and comparable initial characteristics and surgical techniques in both groups (P > 0.05). Intraoperative heart rate, mean blood pressure, additional analgesia, postoperative Wong-Baker scale, postoperative rescue analgesia,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 90 participants or records.
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