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Postoperative care after tonsillectomy: what's the evidence?
Patrick Carpenter1, Daniel Hall, Jeremy D Meier
1Division of Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Current Opinion in Otolaryngology & Head and Neck Surgery
|October 14, 2017
Summary
Postoperative pain management after tonsillectomy in children remains challenging. While acetaminophen and ibuprofen are common, concerns about bleeding with ibuprofen persist, and further research into adjunctive therapies is needed.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Otolaryngology
Background:
- Adenotonsillectomy is a common pediatric procedure.
- Postoperative pain and bleeding are significant morbidities.
- Effective pain management strategies are crucial.
Purpose of the Study:
- To review current literature on pediatric tonsillectomy postoperative management.
- To evaluate pain control and bleeding risk strategies.
Main Methods:
- Literature review of current studies.
- Analysis of medication regimens and adjunctive therapies.
Main Results:
- Controversy exists regarding optimal pain medication.
- Acetaminophen and ibuprofen are standard; ibuprofen raises hemorrhage concerns.
- Adjunctive therapies like dexamethasone, ketamine, and local lidocaine may reduce pain.
- Dexamethasone shows no increased bleeding risk.
Conclusions:
- Optimal pain management post-tonsillectomy is not definitively established.
- Several medications and therapies show potential benefits.
- Careful consideration of risks and benefits is necessary for treatment selection.