Topical Ropivacaine Combined With Dexamethasone Spray Relieves Post‐Tonsillectomy Pain in Adults

ABSTRACT Objective To evaluate the efficacy of ropivacaine with dexamethasone spray for postoperative pain relief in adults undergoing tonsillectomy. Methods A total of 172 adult patients were randomly assigned to four groups: RD group ( n = 43) received topical 1% ropivacaine with dexamethasone spray, RP group ( n = 43) received topical 1% ropivacaine spray, Saline group ( n = 43) received topical saline spray, and Control group ( n = 43): not receive any interventions. The groups were compared on resting pain scores at 1, 2, 3, 5, 7, and 10 days, changes in pain scores over 10 days, adverse reactions (including dizziness, nausea, difficulty opening the mouth, and pharyngeal foreign body sensation), the time to first solid food intake, the time to first oral pain medication, and total pain medication dosage within 10 days postoperatively. Results The RD group had significantly lower resting pain scores at 1, 2, 3, 5, 7, and 10 days compared to the other groups, as well as a greater decrease in pain scores over 10 days, correlated with Body Mass Index (BMI) and independent of age. They also had earlier postoperative oral intake of solid food, reduced need for remedial analgesics, and lower incidence of difficulty opening the mouth, halitosis, and pharyngeal foreign body sensation compared to the RP, Saline, and Control groups. Conclusion Topical 1% ropivacaine with dexamethasone spray is easy to administer for postoperative tonsillar pain relief in adults. The dosage can be adjusted to meet patient needs, effectively addressing pain with fewer side effects, making it clinically useful and applicable. Level of Evidence: 2.