الفهرس 
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Abstract
Introduction : Tonsillectomy currently remains one of the most commonly performed surgical procedures. Post-operative odynophagia causes minimal oral intake, dehydration, infection and may be secondary hemorrhage. Variable drug combinations were tried to get the maximum control of post-tonsillectomy pain as an adjuvant to general anesthesia. These include acupuncture, antibiotics, local anesthetics, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, speech therapy and steroids etc. Lornoxicam is a potent non-selective NSAID of the oxicam class with analgesic anti-inflammatory and anti-pyretic properties. It was reported to be the most potent balanced inhibitor of human cyclo-oxygenase (COX)-1/-2 enzyme. The Aim of this study : To compare the analgesic efficacy of Peritonsillar infiltration of bupivacaine only versus Lornoxicam with bupivacaine on post-tonsillectomy pain in children. Materials and methods: After the approval of ethical committee (IRB) of Mansoura University, Faculty of medicine, this study was performed at ENT anesthesia unit in Mansoura University Hospital from March 2019 to September 2020, on 66 patients of American society of anesthesiologist (ASA) physical status grade I or II, aged 6 to 12 years of either sex and scheduled for elective tonsillectomy, an informed written consent was taken from the parents. Patients were randomly allocated into one of the two study groups with 33 patients in each group by the closed envelop method : • group B: (receive bilateral peritonsillar infiltration of 0.25% bupivacaine 0.2 mg/kg) with total volume of 4ml. • group BL: (receive bilateral peritonsillar infiltration of 8 mg lornoxicam plus 0.25% bupivacaine 0.2 mg/kg) with total volume of 4ml. Results : The current study demonstrated that, addition of lornoxicam (8 mg) to bupivacaine (0.25% bupivacaine 0.2 mg/kg) provides better analgesic effect, reduction in pain intensity, minimal post-operative analgesic requirement compared with the administration of bupivacaine alone in terms of peritonsillar infiltration with considerable safety profile.