الفهرس 
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Abstract
Tonsillectomy is a one of the most frequently pediatric surgery. Tonsillectomy is a surgical procedure in which each tonsil is removed from a recess in the side of the pharynx called the tonsillar fossa. The procedure is performed in response to repeated occurrence of acute tonsillitis, sleep surgery for obstructive sleep apnea, nasal airway obstruction, diphtheria carrier state, snoring, or peritonsillar abscess.Post-tonsillectomy pain thought to be mediated by noxious stimulation of C afferents fiber which located in peritonsillar space. Moreover, it is may be stimulated by inflammation, nerve irritation and exposed pharyngeal muscle spasm. Traditionally, Post-tonsillectomy pain was treated with opioid analgesics and non-steroidal anti-inflammatory drugs but it was associated with increased risks of respiratory depression and postoperative bleeding.The present study has been planned to assess post tonsillectomy analgesic efficacy of peritonsillar lidocaine infiltration with dexmedetomidine rather than each drug alone and possible postoperative complication in children undergoing tonsillectomy.Eligible patients (n=90) were randomly divided into three equal groups (30 patients in each), using a closed-envelope method. The patients and the administrator were blinded to the medication administered. The study solutions were prepared by an anesthesiologist who was blinded to the study.Anesthesia was standardized for all patients. General anesthesia was induced with 8% sevoflurane in 100% oxygen through a face mask. After establishing a venous access, atracurium .5 mg/kg was given. Orotracheal intubation was performed and anesthesia was maintained with 2-3% sevoflurane in oxygen/air mixture and the patients were mechanically ventilated to keep end tidal CO2 (ETCO2) of about 35 mmHg. Hemodynamic changes (mean blood pressure and heart rate) and oxygen saturation will be recorded basely then every 5 min intra operatively. Sevoflurane concentration was increased if the heart rate or the mean arterial blood pressure increased 20 % of the basal value.At the end of the surgery, sevoflurane was discontinued, residual muscle relaxation was reversed with neostigmine 0.04 mg/kg and atropine 0.02 mg/kg IV. The oropharynx was suctioned and extubation was performed when the patients’ gag reflex was restored and they showed facial grimaces or purposeful appearing motor movements then the patients were transferred to post anesthesia care unit (PACU) and followed up for 24 hrs.Anesthesia time (from the start of induction of anesthesia till extubation), Operative time (from the start of surgery till end of surgery) and Extubation time (from stopping the anesthetics till extubation) were recorded.In our study we concluded that the use of lidocaine with dexmedetomidine better than using each drug alone in decreasing post tonsillectomy pain and increasing 1st analgesic request with no postoperative side effect.