Anesthetic injections and analgesia use in pediatric post-tonsillectomy patients: A meta-analysis and systematic review

To assess the effect of local anesthetic injection on post-operative analgesia and complications for pediatric tonsillectomies on post-operative day (POD) 0 and 1. A 2-researcher team following the PRISMA guidelines performed a systematic review and meta-analysis. The databases Pubmed.gov, Embase, W...

Full description

Saved in:
Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2022-01, Vol.152, p.110976-110976, Article 110976
Main Authors: Ortega, Briana, Stramiello, Joshua A., Brigger, Matthew, Nation, Javan
Format: Article
Language:English
Subjects:
Analgesia
Anesthetic injection
Anesthetics, Local
Child
Humans
Narcotic
Pain Management
Pain, Postoperative - drug therapy
Pain, Postoperative - etiology
Pain, Postoperative - prevention & control
Pediatric
Tonsillectomy
Tonsillectomy - adverse effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To assess the effect of local anesthetic injection on post-operative analgesia and complications for pediatric tonsillectomies on post-operative day (POD) 0 and 1. A 2-researcher team following the PRISMA guidelines performed a systematic review and meta-analysis. The databases Pubmed.gov, Embase, Web of Science, and Scopus were used. Studies written with original data utilizing a saline injection control arm were selected. Corresponding authors were contacted for missing data, which was used when possible. The collated data was analyzed with Review Manager (RevMan) Version 5.4., The Cochrane Collaboration, 2020. Surgical technique subgroup analysis was performed. 319 publications were identified and 8 articles with 12 total experimental arms (529 participants) were selected. Local anesthetic injection was compared to saline injection. The standard mean difference for time until first analgesic was 0.68 min [0.26, 1.09](P = 0.001) in favor of local anesthetic. The odds ratio (OR) for patients receiving one or more narcotic doses on POD 0 was 0.22 [0.06, 0.84](P = 0.03) in favor of local anesthetic. Use of an intraoperative anesthetic injection during pediatric tonsillectomy can help improve initial recovery as it delays the need for narcotic medication and may reduce postoperative narcotic usage on POD 0 and 1. In addition, a local anesthetic does not increase the risk of postoperative bleeding or dehydration.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2021.110976