Comparing Ultrasound-Guided Nerve Blocks with Standard Pain Relief for Children Having Adenotonsillectomy Surgery

What this Trial Is About

Researchers are evaluating the use of bilateral ultrasound-guided glossopharyngeal nerve block UGGNB and maxillary nerve block UGMNB compared to conventional multimodal analgesia for children undergoing adenotonsillectomy. The study focuses on assessing pain relief methods during and after tonsillectomy surgery in pediatric patients aged 5 to 13 years. This interventional trial involves random assignment to different pain management approaches to understand their effects on postoperative recovery. Participants receive premedication with oral midazolam before surgery and standard anesthesia care including fentanyl, propofol or sevoflurane, atracurium, and dexamethasone. Those in the block group undergo ultrasound-guided nerve blocks performed by an expert anesthesiologist immediately after anesthesia induction. The conventional group receives a single intravenous dose of paracetamol. Surgery is performed using the same electro-dissection technique for all. Postoperative pain is managed with ibuprofen and pethidine as needed, and antiemetics are given for nausea or vomiting. During the study, participants are closely monitored with standard vital signs and heart rate checks, with additional fentanyl doses given for increased heart rate or blood pressure. Pain is assessed using Wong-Baker FACES or VAS scales at specific intervals during the first 24 hours after surgery. Parents are instructed to monitor pain at home and report medication use by phone. Researchers measure time to first rescue analgesia as the primary outcome, along with heart rate, fentanyl use, pain scores, bleeding, and dietary intake as secondary outcomes. Safety is monitored for possible nerve block complications and local anesthetic toxicity.

Glossopharyngeal and Maxillary Nerve Blocks in Adenotonsillectomy