Effectiveness of Perioperative Ropivacaine Infiltration in Paediatric Tonsillectomy: A Systematic Review and Meta-Analysis
Year: 2025
Type: preprint
Study designs: Systematic Review, Meta-Analysis
Abstract: Objective : Identify and summarise the efficacy of Ropivacaine for paediatric tonsillectomy in reducing post operative pain and complications and improving patient outcomes. Data Sources : Embase, Medline, and CINAHL Review Methods : A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Articles were screened, and eligibility criteria applied. Risk of bias was evaluated, and data extraction was performed. SPSS was used for statistical analysis of the post-operative patient outcomes including VAS score, mCHEOPs and Maunuksela pain scores, as well as time until analgesia was given post-operatively. Results: Three studies met the inclusion criteria with a total of 130 participants. Meta-analysis revealed a statistically significant difference between ropivacaine infiltration and placebo. Heterogeneity among studies was moderate, with a variety of reported outcomes. The primary and secondary outcomes of the review showed statistical significance, notably, post-operative pain, time to first analgesia, and total analgesia consumption. Post operative nausea and vomitus (PONV) was statistically reduced in ropivacaine infiltration in one of the studies. Conclusion: Ropivacaine peritonsillar infiltration resulted in significant improvements across primary and secondary outcomes. This intervention can be advocated for paediatric tonsillectomy patients. Future studies should evaluate different dosages and administration techniques, as well as pain post-discharge and utilise a standardised post-operative pain tool to report outcomes and reduce heterogeneity. Keywords: paediatric tonsillectomy, meta-analysis, systematic review, ropivacaine infiltration, post-operative pain
Authors: Alaa Abdelhalim, Gyleen Elegio, Nitalia Sheikh, Fangxing Yin, Isabella Petrie, Hassan A. Elhassan
Institutions: Queen Mary University of London, Homerton University Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4413894659