MedPath

Pain Management in Pediatric Adenotonsillectomy

Phase 3
Not yet recruiting
Conditions
Pain Management
Interventions
Registration Number
NCT05928520
Lead Sponsor
Al-Azhar University
Brief Summary

Tonsillectomy is considered one of the most frequent minor surgeries conducted on a day-case basis on children, and usually associated with pain and sore throat. This study aimed to include 80 children, ASA physical status I\&II aged 4-15 years, and undergoing tonsillectomy. The purpose of this study is to determine the analgesic efficacy of topically applied lidocaine and tramadol in relieving post-operative pain in children following tonsillectomy.

Detailed Description

Pain and sore throat following tonsillectomy are typical. As a result, the issue of adequate post-tonsillectomy pain management remains a significant therapeutic obstacle. Several medications, including nonsteroidal anti-inflammatory drugs, corticosteroids and narcotics have been utilised to alleviate pain following tonsillectomy. Nevertheless, they have numerous undesirable negative consequences. NSAIDs may impede hemostasis and increase the propensity for bleeding. Opioid may result in respiratory depression, nausea, and vomiting. Consequently, the major purpose of this study is pain alleviation with minimal adverse effects.

This prospective, randomized, double-blind controlled clinical study will include 80 children, undergoing tonsillectomy, to receive either topical tramadol 5% or lidocaine 2%. Modified Visual Analogue Scale (m-VAS), bleeding, nausea, vomiting, sore throat, otalgia, fever, halitosis, and constipation will be recorded.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Recurrent acute tonsillitis
  • Chronic tonsillitis
  • Tonsillar hypertrophy with or without obstructive sleep apnea
Exclusion Criteria
  • Parent refusal
  • Hypersensitivity
  • History of bronchial asthma
  • Renal impairment
  • Impaired liver function
  • Bleeding disorders

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Lidocaine groupLidocaine 2%Swabs soaked with lidocaine 2% 2mg /kg diluted with saline 0.9%
Tramadol groupTramadol 5%Swabs soaked with tramadol 5% 2 mg/kg diluted with saline 0.9%
Tramadol groupLidocaine 2%Swabs soaked with tramadol 5% 2 mg/kg diluted with saline 0.9%
Lidocaine groupTramadol 5%Swabs soaked with lidocaine 2% 2mg /kg diluted with saline 0.9%
Primary Outcome Measures
NameTimeMethod
modified visual analogue pain score (m-VAS)"day 7" after surgery

It is 0-10 scale, color-coded (blue to red) scale. The scale also included depictions of faces, from happy to sad. Zero indicates no pain, 1-3 indicates mild pain, 4-7 indicates moderate pain, and 8-10 indicates severe agony.

Secondary Outcome Measures
NameTimeMethod
FeverWithin 7 days after surgery

Percentage of cases

HalitosisWithin 7 days after surgery

Percentage of cases

OtalgiaWithin 7 days after surgery

Percentage of cases

TrismusWithin 7 days after surgery

Percentage of cases

Time to first oral fluid intakeWithin the first day after surgery

It is measured in hours, beginning from the end of the procedure

Post-tonsillectomy bleedingWithin 7 days after surgery

Percentage of cases

Time to first ibuprofen rescue analgesiaWithin 7 days after surgery

The time from the end of the surgical procedure to the first request of ibuprofen in minutes

Time to first oral solid intakeWithin the first day after surgery

It is measured in hours, beginning from the end of the surgery

Postoperative nausea and vomitingWithin 7 days after surgery

Percentage of cases

© Copyright 2025. All Rights Reserved by MedPath