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Effect of Cryotherapy plus Flurbiprofen Axetil for Pain Management in Children Undergoing Tonsillectomy
Ping Gao1, Wenyun Wang2, Wenhui Yang2
1School of Nursing, Anhui Medical University, Department of Emergency Medical, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230032, China.
Insights
Combining cryotherapy with flurbiprofen axetil effectively reduces post-tonsillectomy pain and delirium in children. This combination therapy enhances recovery without significant adverse events, offering a promising approach for pediatric pain management.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Surgical Recovery
Background:
- Tonsillectomy is a common pediatric surgical procedure associated with significant postoperative pain and potential for delirium.
- Effective pain management strategies are crucial for optimizing recovery and patient experience after tonsillectomy.
Purpose of the Study:
- To evaluate the combined efficacy of cryotherapy (ice pops) and flurbiprofen axetil for analgesia and preventive analgesia in children undergoing tonsillectomy.
- To assess the impact of these interventions on pain scores, emergence delirium, and postoperative complications.
Main Methods:
- 120 children were randomized into four groups: control, flurbiprofen axetil alone, cryotherapy alone, and combined cryotherapy plus flurbiprofen axetil.
- Flurbiprofen axetil was administered intravenously 30 minutes pre-surgery; cryotherapy (ice pops) was given post-anesthesia recovery.
- Pain (mCHEOPS) and delirium (PAED) scores were assessed at multiple time points postoperatively.
Main Results:
- Both flurbiprofen axetil and cryotherapy, individually and in combination, significantly reduced pain and delirium scores compared to the control group from 5 minutes to 4 hours postoperatively.
- The combination group (cryotherapy plus flurbiprofen axetil) demonstrated significantly lower pain and delirium scores at 30 minutes postoperatively compared to either intervention alone.
- No significant differences in pain or delirium scores were observed between groups at 24 hours postoperatively, and no significant differences in postoperative complications were noted.
Conclusions:
- The combination of cryotherapy and flurbiprofen axetil offers superior short-term pain and delirium mitigation following pediatric tonsillectomy.
- This combined approach appears safe and effective in facilitating early recovery after tonsillectomy.
- Further research may explore optimal timing and duration for sustained pain relief.
Objective:
To investigate the effect of cryotherapy using ice pops for physical analgesia and preventive analgesia using flurbiprofen axetil for pain management in children undergoing tonsillectomy.
Methods:
A total of 120 children scheduled for tonsillectomy were recruited after assessment for eligibility and assigned to a control group (group C), flurbiprofen axetil group (group F), cryotherapy group (group I), and cryotherapy plus flurbiprofen axetil group (Group FI) via the random number table method. Groups F and FI were given 1 mg/kg of flurbiprofen axetil through intravenous injection 30 min before surgery, while group C received an equal amount of saline at the same time point. Groups I and FI received sweet ice pops for pain relief after recovery from anesthesia. The modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) scores and pediatric anesthesia emergence delirium (PAED) scores at 5 minutes (T1), 30 minutes (T2), 60 minutes (T3), 4 hours (T4), and 24 hours (T5) postoperatively, and the incidence of postoperative complications in the children were recorded by investigators who were masked to the grouping results.
Results:
From T1 to T4, significantly lower mCHEOPS scores and PAED scores were observed in group F, group I, and group FI versus those in group C (P < 0.05). At T2, group FI showed significantly lower mCHEOPS scores and PAED scores versus groups F and I (P < 0.05). There were no significant differences in the mCHEOPS scores and PAED scores between the four groups at 24 h postoperatively (P > 0.05). The differences in the documented postoperative complications between the four groups did not come up to the statistical standard (P > 0.05).
Conclusion:
Cryotherapy plus flurbiprofen axetil for pain management significantly mitigates post-tonsillectomy pain and delirium in children and facilitates recovery, with no significant adverse events.
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