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Objective: Post-tonsillectomy pain is one of the most frequent morbidities of tonsillectomy surgery. Currently, there is no standard protocol for post-tonsillectomy pain control. In our study, we aimed to compare the effects of perioperative peritonsillar dexamethasone-bupivacaine and bupivacaine-alone infiltration on pain control in pediatric patients., Materials and Methods: This prospective, randomized, double-blind, controlled clinical trial was conducted between February 2018 and May 2018 in a single-center tertiary education and research hospital, otorhinolaryngology/head and neck surgery clinic, under general anesthesia, which included 120 pediatric patients between the ages of 2-12 (mean 5.7 ± 1.8), and who were with ASA (American Society of Anesthesiologists) I-II classification. Patients were randomly divided into three groups as 40 participants in each group. Group 1 consisted of patients who were injected with dexamethasone-bupivacaine into their peritonsillar region, group 2 consisted of patients who were injected with bupivacaine only, and group 3 consisted of patients who were injected with saline only as the control group. FLACC (face, legs, activity, cry, consolability) Scale and Wong-Baker FACES ® Pain Rating Scale (WBS) were used for early and late period postoperative pain scoring. Patients with pain score ≥ 4 were treated with paracetamol rescue analgesia. Side effects such as nausea, vomiting and bleeding were recorded. Data of all groups were compared statistically and p ≤ 0.05 was considered statistically significant., Results: There was no significant difference between the groups in terms of demographic data, duration of operation and duration of anesthesia. The pain scores of group 1 were significantly lower than those of the control group except for postoperative 45th min, 2nd day and 3rd day. The pain scores of the group 1 were significantly lower at all times except for the postoperative 12th and 24th hour, than those of group 2. The pain scores of the group 2 were lower than the control group only at postoperative 7th day, but no significant difference was found at other times. No statistically significant difference was found between the groups in terms of requirement rates for the first 60 min recovery analgesia (p = 0.686). No statistical difference was found between the groups in terms of side effects., Conclusion: In our study, preoperative local dexamethasone-bupivacaine infiltration in pediatric patients was shown to be more effective than bupivacaine-only and serum-only infiltration for early and late post-tonsillectomy pain control.

Objective: To investigate the beneficial effect of adenotonsillectomy (AT) on nocturnal enuresis (NE) in children with adenotonsillar hypertrophy and evaluate the Modified Pediatric Epworth Scale (MPES)., Methods: This was a prospective study comparing preoperative and postoperative evaluation of the frequency of NE and MPES in pediatric obstructive sleep apnea (OSA). A questionnaire on NE history was prepared based on the Turkish Enuresis Guidelines. NE histories were evaluated pre- and postoperatively on the first month and third month, respectively. MPES questions were asked to the parents of all the OSA patients pre- and postoperatively, and scores were noted., Results: Eighty-four (84) pediatric OSA patients were involved in the study. Preoperatively, 19 patients (27%) complained about nocturnal enuresis. After the surgery, 52% of the patients with NE had complete resolution of NE (p < 0.001). Postoperatively, the average Epworth scores of both groups significantly decreased (p < 0.001)., Conclusion: There is a strong correlation between OSA and NE. In the present study, enuresis in pediatric OSA patients significantly decreased after surgery. Also, Epworth scores decreased significantly after surgery. In children with nocturnal enuresis, the presence of OSA symptoms should be questioned., (Copyright © 2017 Elsevier B.V. All rights reserved.)