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Pain management after tonsillectomy-by demand or by-the-clock-is there a difference?
Magdalena Gostian1, Lisa Stilkerich2, Anne Pauly3
1Department of Anesthesiology and Intensive Care Medicine, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany.
Ear, Nose, & Throat Journal
|July 21, 2022
Summary
A fixed pain management protocol did not improve post-tonsillectomy pain control compared to on-demand treatment. Current analgesic strategies for tonsillectomy remain insufficient, necessitating further research into effective pain management.
Area of Science:
- Otolaryngology
- Pain Management
- Anesthesiology
Background:
- Post-tonsillectomy pain significantly impacts patient recovery and quality of life.
- Current pain management strategies often involve individualized treatment, with variable outcomes.
Purpose of the Study:
- To compare the efficacy of a fixed-scheduled analgesic protocol versus on-demand pain management after tonsillectomy (TE).
- To evaluate pain levels, analgesic use, side effects, and patient satisfaction.
Main Methods:
- Prospective trial involving 80 patients undergoing TE.
- Control group received individual analgesic treatment on demand.
- Intervention group received a fixed-scheduled four-staged escalating analgesic protocol.
- Pain intensity (minimum, maximum, ambulation), analgesic score, side effects, and patient satisfaction were assessed using the QUIPS questionnaire.
Main Results:
- No significant differences in minimum pain, maximum pain, or pain on ambulation between the two groups.
- Patient satisfaction levels were comparable between the on-demand and fixed-schedule groups.
- Similar rates of treatment-related side effects, functional impairments, and requests for additional analgesia were observed.
Conclusions:
- A fixed-scheduled analgesic protocol does not offer distinct advantages over individual on-demand pain management for post-tonsillectomy pain.
- Current pain control following tonsillectomy remains suboptimal.
- Further research is required to develop standardized and effective treatments addressing the pathophysiology of post-tonsillectomy pain.
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