About this trial
Tonsillectomies are among the most common surgical procedures performed in pediatric populations, with more than 14,000 procedures performed annually in Ontario, with more than 80% being performed to treat sleep-disordered breathing, including sleep apnea. Despite being a routine procedure, postoperative pain is a prevalent challenge following tonsillectomies, with significant pain lasting 7 to 10 days and peaking within the first 3 days following surgery. Effective pain management is critical not only to enhance patient comfort, but to ensure functional recovery, decrease the risk of post-surgical complications, and reduce the risk of hospital readmissions. The suprazygomatic maxillary nerve block (SZMN block) has become a promising alternative to opioids for the management of post-tonsillectomy pain. The SZMN block numbs the nerves in the facial region that would contribute to feeling pain following tonsillectomy. Although the SZMN block has been successful in adult tonsillectomies and pediatric cleft palate repairs, its success in pediatric tonsillectomies remains under investigation. This randomized controlled trial aims to evaluate the efficacy and safety of the SZMN block in pediatric tonsillectomy and adenotonsillectomy patients, through its role in providing pain management over 14 days following surgery. This study will be conducted at Victoria Hospital, London Health Sciences Centre.
Eligibility criteria
Qualifiers
Patients undergoing coblation intracapsular tonsillectomy or adenotonsillectomy for sleep apnoea.
Between 3-9 years old (inclusive).
Patient(s) and guardian(s) can consent to participate in the study.
Legal guardian(s) can read and write in English.
Disqualifiers
Patient or legal guardian refusal to participate in the study.
Emergency surgery.
Allergies to local anesthetics.
Patients with coagulopathy.
Trial design
Treatments tested in this trial
- Suprazygomatic maxillary nerve block (SZMN) with bupivacaine
- Suprazygomatic maxillary nerve block (SZMN) with placebo