Management of pain in peritonsillar abscess

A prospective study was undertaken in 75 patients with peritonsillar abscess to determine the treatment that was most effective in relieving the excruciating pain associated with the condition. The patients were divided into three treatment groups: intravenous antibiotic, aspiration, and incision and drainage. The effect of treatment on pain was objectively assessed by serially measuring the upper to lower incisor distance and by giving the patient water to drink at regular intervals to determine the point at which swallowing was pain-free. The improvement of the mean upper to lower incisor distance 15 minutes after the initial treatment was five per cent in the intravenous antibiotic group, 38 per cent in the aspiration group, and 100 per cent in the incision and drainage group. None of the patients in the intravenous antibiotic group was able to swallow water two hours after the initial treatment. In the same time interval two patients (eight per cent) in the aspiration group and 23 patients (92 per cent) in the incision and drainage group were able to swallow water. The conclusion derived from this study is that incision and drainage is superior to intravenous antibiotic and aspiration in relieving the pain associated with peritonsillar abscess.