European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Glossopharyngeal nerve block versus tonsillar fossa ropivacaine infiltration within multimodal analgesia for pediatric post-tonsillectomy pain: a randomized controlled clinical trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Faramarzi Mohammad, Nemati Maryam, Farbood Arash, Faramarzi Ali
Аннотация
PURPOSE: Pediatric tonsillectomy is associated with substantial postoperative pain. We compared glossopharyngeal nerve block (GNB) with peritonsillar ropivacaine infiltration (RI) within multimodal analgesia.
METHODS: In this double-blind randomized trial, 90 children (4-10 years) undergoing day-case tonsillectomy were randomly allocated in a 1:1:1 ratio (30 per group) to receive bilateral GNB with 0.2% ropivacaine, RI with 0.2% ropivacaine, or sham control. The primary outcome was post-anesthesia care unit (PACU) pain measured by the Face, Legs, Activity, Cry, Consolability (FLACC) scale; secondary outcomes included pain at rest and during swallowing measured by the Wong-Baker FACES Pain Rating Scale (FACES) at rest and during swallowing (2-24 h), time to first analgesic request, nausea, sleep quality, parental satisfaction, and adverse events.
RESULTS: Time to first analgesic request was significantly longer in the GNB group than in the control group (median 240 vs. 120 min; P < 0.001). Pain at rest was lower with GNB than control from 2 to 12 h and lower than RI at 6 h, and swallowing pain was lower with GNB than both comparators from 2 to 24 h (all P ≤ 0.008) . Nausea was less frequent with GNB (6.7%) than RI (20%) or control (33.3%) (P = 0.036), and sleep quality and parental satisfaction were higher with GNB (P = 0.010 and P < 0.001). PACU FLACC and sedation scores were similar, and no serious anesthetic-related arrhythmias or bronchospasm were observed.
CONCLUSIONS: Within the studied multimodal analgesic regimen, bilateral GNB with 0.2% ropivacaine was associated with lower postoperative pain scores, improved swallowing comfort, longer time to first rescue analgesia, and better caregiver-reported outcomes in this randomized cohort, without increased sedation or observed major anesthetic-related complications.
METHODS: In this double-blind randomized trial, 90 children (4-10 years) undergoing day-case tonsillectomy were randomly allocated in a 1:1:1 ratio (30 per group) to receive bilateral GNB with 0.2% ropivacaine, RI with 0.2% ropivacaine, or sham control. The primary outcome was post-anesthesia care unit (PACU) pain measured by the Face, Legs, Activity, Cry, Consolability (FLACC) scale; secondary outcomes included pain at rest and during swallowing measured by the Wong-Baker FACES Pain Rating Scale (FACES) at rest and during swallowing (2-24 h), time to first analgesic request, nausea, sleep quality, parental satisfaction, and adverse events.
RESULTS: Time to first analgesic request was significantly longer in the GNB group than in the control group (median 240 vs. 120 min; P < 0.001). Pain at rest was lower with GNB than control from 2 to 12 h and lower than RI at 6 h, and swallowing pain was lower with GNB than both comparators from 2 to 24 h (all P ≤ 0.008) . Nausea was less frequent with GNB (6.7%) than RI (20%) or control (33.3%) (P = 0.036), and sleep quality and parental satisfaction were higher with GNB (P = 0.010 and P < 0.001). PACU FLACC and sedation scores were similar, and no serious anesthetic-related arrhythmias or bronchospasm were observed.
CONCLUSIONS: Within the studied multimodal analgesic regimen, bilateral GNB with 0.2% ropivacaine was associated with lower postoperative pain scores, improved swallowing comfort, longer time to first rescue analgesia, and better caregiver-reported outcomes in this randomized cohort, without increased sedation or observed major anesthetic-related complications.