The. primary aim of the study, To evaluate post operative pain score after platelet rich plasma and
bupivacaine injection in tonsillar bed/anterior tonsillar pillar using Visual
analogue score (VAS).
2. To evaluate wound healing between the platelet rich plasma and bupivacaine
using a five grade scale based on percentage of slough coverage. Tonsillectomy remains one of the most frequently performed otolaryngologic operations and
post operative pain and healing remains major problems for the patients. Pain is due to mucosal injury, muscle injury and exposed cranial nerve endings leading to
inflammation and spasm of pharyngeal musculature. After tonsillectomy high degree of
swelling within 24 hours in uvula and anterior tonsillar pillar and posterior tonsillar pillar may
hinder with healing and is associated with increased post operative complication. It can lead to
decreased oral intake, vomiting, difficulty breathing and dehydration requiring hospital re-admission. Bupivacaine is a long acting local anaesthetic of the amino amide group. It is indicated for
infiltration anesthesia, nerve block, epidural and intrathecal anesthesia. It can also be used in
surgical area by infiltration or by local application . By blocking the afferent nerve endings
through the inhibition of voltage gated ion channels it decreases the onset of post operative
pain. Platelet rich plasma (PRP) have been used for various indications for many years, resulting in
interest in potential autologous PRP in regenerative medicine. It is a suitable option with
clinical benefits, with positive clinical outcomes. PRP which is also known as platelet enriched plasma, platelet rich concentrate, autologous platelet gel and platelet releasate. It is defined as part of plasma fraction of autologous peripheral blood that has a platelet concentration above baseline. The serum contains epidermal growth factor, tumor growth
factor beta firbronectin, all of which have the property of speeding the process of
epithelisation. It also has antibacterial properties because of immunoglobulin G and lysozyme
ingredients. The objective of the study is to evaluate the clinical efficacy of PRP and bupivacaine in
reducing postoperative pain and promoting tissue healing following tonsillectomy. By
systematically assessing pain levels and the healing process in the postoperative period, this
study aims to generate evidence that may guide future clinical practice. The results are
expected to help otolaryngologists enhance postoperative care, reduce patient discomfort, and
improve recovery outcomes in individuals undergoing tonsillectomy. |