ESRA Academy. Antunes C. Sep 8, 2016; 138622; 0508 Topic: REGIONAL ANAESTHESIA TECHNIQUES - BLOCK PERFORMANCE
Claudia Antunes
Claudia Antunes

Access to Premium content is currently a membership benefit.

Click here to join ESRA or renew your membership.

Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

Analgesia for tonsillectomy in adults still representing a great challenge. The authors present five case reports of patients to whom tonsillectomy was performed under general anesthesia (GA) and bilateral palatine nerve block (BPNB).


All patients were purposed to tonsillectomy under GA. After induction, the anesthesiologist performed BPNB, with 25G, 16 mm needle. After identifying great palatin foramen, the needle was introduced until osseous contact is felt and, afterwards, administered 0,5 to 1mL each side of levobupivacaine 0,25%. All patients receive an initial dose of 3mcg/kg fentany, iv dexamethasone 8mg and iv paracetamol 1g. In the recovery room (RR), the patient was asked about VAS pain and opioid analgesia if superior to 3. VAS was also evaluated at 24h and 1 week after surgery.


  Age Sex VAS RR Opioid dose RR VAS 24h VAS 7 days
Case 1 27 F 1/10 0 0/10 0/10
Case 2 18 F 1/10 0 1/10 1/10
Case 3 18 M 1/10 0 1/10 1/10
Case 4 40 F 1/10 0 1/10 2/10
Case 5 19 M 4/10 Morphine 2mg 2/10 3/10


Tonsillectomy surgery in adults is normally associated to severe pain. These case reports shows that BPNB markedly lowers VAS, not only the immediate postoperative pain, but also maintaining lower VAS to one week after surgery. The authors suggest that the use of iv dexamethasone could extend LA effect and the block increases the long term pain threshold, so BPNB is a promising technique to pain control in tonsillectomy.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings