Post-tonsillectomy pain: Different modes of pain relief

Sixty patients aged 15 to 40 years of either sex, American Society of Anaesthesiologists (ASA) grade I and II, undergoing tonsillectomy, were randomly allocated to receive either preroperative intramuscular diclofenac sodium(group A) or pre- incisional bilateral infiltration of bupivacaine in the peritonsillar fossa (group B) or post operative Trunscutaneous Electric Nerve Stimulation - TENS (group C) at fixed time intervals. Pain scores (Visual analogue scale VAS, 0- 100 mm) were assessed at rest and on deglutition at 1,3,6,9,12 and 24 hours after surgery. Pentazocine 1actale 15 mg IV was given as rescue analgesic whenever VAS estimation was more than 30 mm at rest (not deglutition). Constant incisional pain was significantly less ( p < 0.01 ANOVA) in group C after 3 hours of surgery as compared to group A and B. Similarly pain on deglutition was significantly less (p <0.01, ANOVA) in group C during the entire study period as compared to Group A and B. There was significant reduction of VAS (p< 0.01) immediately after TENS therapy at 0, 4 and 8 hours. Rescue analgesic consumption was significantly lower in TENS group. Thus, TENS seems to be an effective therapeutic modality for post tonsillectomy pain relief as compared to the other two methods.