Effect of peri-tonsillar infiltration of ropivacaine and adrenaline on intra operative bleeding

Abstract

Hemorrhage after tonsillectomy occurs most commonly till 10 days after surgery. Hemorrhage occurs when scabs begin sloughing off from the surgical sites. The risk of hemorrhage is approximately 1-2%. It is higher in adults, especially males and in 75% of the cases the hemorrhage occurs on the day of surgery. Dissection tonsillectomy was done in all the cases. Ropivacaine (0.75%) with Adrenaline
(1:200000) was locally infiltrated on the right side (R-side) in the Peritonsillar region before the surgery and in the Tonsillar fossa after the surgery. The left side was considered as the control side. Intraoperative blood loss was estimated by weighing the swabs used before and after surgery (1gm=1ml) and adding it to the total volume of blood collected in respective suction bottles separately on both the sides 17(56.7%) females and 13(43.3%) males participated in the study. Majority of the cases belonged to <10 years of age group. Mean blood loss was 75.73ml on the Right side and 88.6ml on the left side (p value <0.0001). The peri-tonsillar infiltration of Ropivacaine (0.75%) with Adrenaline (1:200000) is effective and significant in reducing intra-operative bleeding during the surgery.