Oral dantrolene sodium for tonsillectomy pain: a double-blind study

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Tonsillectomy in adults and older children causes significant postoperative pain, typically lasting 7-14 days.
• Pharyngeal muscle spasms are suspected as a major contributor to this pain.
• Dantrolene sodium, used for malignant hyperthermia, was investigated for its potential muscle relaxant properties in pain management.

Purpose of the Study:

• To evaluate the effectiveness of dantrolene sodium in reducing pain after tonsillectomy.
• To assess the impact of dantrolene sodium on analgesic requirements, diet, activity levels, and side effects.

Main Methods:

• A double-blind, placebo-controlled study involving 113 patients (age ≥ 11 years).
• Patients received either dantrolene sodium (1.5 mg/kg/day) or placebo orally, four times daily for 5 days postoperatively.
• Data collected daily for 2 weeks included pain scores, diet, activity, analgesic use, and side effects. Liver enzymes were also monitored.

Main Results:

• No significant differences were observed in subjective pain, diet, or activity levels between the dantrolene and placebo groups.
• Patients receiving dantrolene sodium required significantly less analgesic medication on postoperative days 2, 3, and 4 (p < 0.05).
• There were no significant differences in side effects or changes in liver enzyme levels between the groups.

Conclusions:

• Dantrolene sodium, at the tested dosage, effectively reduces the need for analgesics following tonsillectomy.
• The findings suggest dantrolene sodium is a viable option for managing pain after tonsillectomy by potentially mitigating muscle spasms.
• Further research may explore optimal dosing and long-term efficacy.