Effect of the glossopharyngeal nerve block of low dose dexamethasone combined with ropivacaine on postoperative pain and inflammation in children after general anesthesia

Objective To observe the glossopharyngeal nerve block of low dose dexamethasone combined with ropivacaine hydrochloride on pain and inflammation in children after tonsillectomy.

Methods Eighty children with ASA grade Ⅰ-Ⅱ scheduled by pediatric tonsillectomy were randomly divided into two groups(40 cases in each group): ropivacaine group(Group L) and combination group(LD Group LD).The Group L was given 0.25% ropivacaine hydrochloride(2 mL), and the Group LD was given 0.25% ropivacaine hydrochloride combined with dexamethasone 0.1 mg/kg(2 mL).The FLACC scores, levels of inflammatory factors and incidence of adverse reactions at rest and during swallowing were recorded immediately after surgery, after 24 h and 48 h of surgery in two groups.

Results The FLACC score in the Group LD was lower than that in L group at 48 h after operation(P < 0.05).The first feeding time of Group LD was earlier than that of Group L(P < 0.01).The levels of C-reactive protein(CRP), interleukin(IL)-1β and IL-6 immediately and at 48 h after surgery in the Group LD were lower than those in Group L (P < 0.05).The incidence of postoperative fever in the Group LD was lower than that in Group L (P < 0.05).

Conclusions The glossopharyngeal nerve block of low dose dexamethasone combined with ropivacaine hydrochloride can obviously reduce the pain after tonsillectomy in children, occurrence of postoperative fever and postoperative inflammation, and provide an effective pre-analgesic method for children tonsillectomy.