Pain Treatment after Tonsillectomy: Advantages of Analgesics Regularly Given Compared with Analgesics on Demand

Abstract

The aim of the present prospective study was to evaluate pain treatment during the first postoperative 24 h for 40 patients (age over 18) undergoing tonsillectomy. Patients were divided into two groups: group A (n = 20) received analgesics on demand and group B (n = 20) on a regular basis. Basic pain treatment consisted of paracetamol 750 mg x 6 and diclofenac 50 mg x 3. Pain measurement was performed using a visual analogue scale (VAS): a 10 cm line with 0 cm equalling no pain and 10 cm equalling the worst pain ever felt. The following parameters were studied: VAS values, the need for rescue analgesics, intra- and postoperative bleeding, nausea and vomiting, postoperative food intake and hospital time. Only 4 of 20 (20%) patients in group B needed rescue analgesics in the postoperative ward compared with 15 of 20 (75%) in group A (p < 0.01, chi2 test). In group B, 13 of 20 (65%) patients could eat solid food before they were discharged from the ward, compared with 7 of 19 (37%) monitored patients in group A (p < 0.01, chi2 test). The observed VAS values were generally rather low in both groups. The mean value for all observed VAS values was less than 4 in both study groups. However, no significant difference in VAS values was observed between the two study groups. Our results suggest that regularly given postoperative pain treatment after tonsillectomy, starting intraoperatively with paracetamol and diclofenac, has significant advantages compared with a regimen in which patients receive analgesics only on demand.

Tonsil Surgery in Youths: Good Results With A Less Invasive Method

“…This is in agreement with the generally held expectation that older people have more pain after tonsil surgery than children. We followed a regime based on results reported by Thorneman and Åkervall, 12 who showed that a regular postoperative schedule for pain treatment after TE has advantages compared with taking analgesics only on demand.…”

Are adjuvant therapies for tonsillectomy evidence based?

“…Only two trials so far have compared regular versus rescue analgesia following tonsillectomy, and the results are conflicting. The earlier trial (non-randomized controlled) found regular analgesia to be more efficacious (better pain control and earlier return to solid feeds), 28 whereas a more recent (randomized controlled) trial found no significant benefit with a regular regimen. 29…”

Measuring Quality of Life in Adult Patients with Chronic Tonsillitis

“…Recently NSAIDS have been shown to be effective in regulating pain after tonsillectomy. Regularly given postoperative pain treatment after tonsillectomy, starting intraoperatively, has shown significant advantages compared with a regimen on demand [26]. Compared with opioids, ( NSAIDs were found to be equianalgesic and the risk of emesis was significantly decreased [27].…”