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Local Application of Honey for Postoperative Pain Management and Associated Outcomes Following Tonsillectomy in
Seyed Javad Hosseini1, Seyed Reza Hosseini2, Amirreza Jamshidbeigi3
1Nursing Department, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran.
Insights
Locally applied honey may reduce pain intensity and analgesic use in children after tonsillectomy. However, more high-quality studies are needed to confirm these findings due to low certainty of evidence.
Area of Science:
- Pediatric Surgery
- Pain Management
- Complementary Medicine
Background:
- Tonsillectomy is a common pediatric surgical procedure associated with significant post-operative pain.
- Evidence regarding the efficacy of honey for post-tonsillectomy pain relief in children is conflicting.
- Previous reviews often failed to differentiate between adult and pediatric populations.
Purpose of the Study:
- To systematically investigate the effect of locally applied honey on pain intensity, analgesic consumption, and pain relief in children following tonsillectomy.
- To address the existing gaps and conflicting evidence in the literature.
Main Methods:
- A systematic search was conducted across major databases (Cochrane Library, ClinicalTrials.gov, MEDLINE, Web of Science, Google Scholar).
- Included were randomized controlled trials (RCTs) comparing honey intervention with standard treatment in pediatric tonsillectomy patients.
- Meta-analysis was performed on pain intensity (VAS tool), analgesic consumption, and time to pain relief, with risk of bias and certainty of evidence evaluation.
Main Results:
- Seven RCTs (n=710) met the inclusion criteria.
- Honey intervention significantly reduced pain intensity (WMD: -0.90, p<0.001) with low certainty of evidence (I²: 92.5%).
- Honey also significantly decreased time to pain relief and analgesic consumption.
Conclusions:
- Locally applied honey demonstrates potential benefits in alleviating post-tonsillectomy pain in children.
- The current evidence is based on studies with varying quality, with only one deemed low risk of bias.
- Further high-quality randomized controlled trials are recommended to confirm these findings and improve confidence in the evidence.
Background:
This study investigates the effect of locally applied honey on pain intensity, analgesia consumption, pain relief and nighttime awakenings in children following tonsillectomy, addressing conflicting evidence and the lack of differentiation between adult and paediatric populations in previous reviews.
Methods:
A systematic search was conducted across multiple databases, including Cochrane Library, ClinicalTrials.gov, MEDLINE, Web of Science and Google Scholar. Randomised controlled trials (RCTs) comparing pain outcomes in children receiving honey in addition to standard treatments versus those receiving standard treatments alone were included. Pain intensity was measured with the VAS tool. Meta-analysis was performed using STATA version 14 software. Also, risk of bias and certainty of evidence were evaluated.
Results:
Out of 537 articles, seven studies (n = 710) with RCT design met the inclusion criteria. The average duration for measuring pain intensity was 7.37 days. Pooled effect size showed a statistically significant reduction in pain intensity in the honey intervention group compared to the control group (WMD: -0.90, 95% CI [-1.32, -0.48], p < 0.001, I 2: 92.5%; certainty of evidence: low). Also, the results demonstrated that honey significantly decreased the average time required for pain relief and analgesic consumption in the intervention group compared to the control group. One study was deemed low risk of bias, four studies were of intermediate quality and two studies were evaluated as high.
Conclusion:
While honey shows promise in reducing post-tonsillectomy pain, cautious use is advised due to the limited quality of evidence. More robust RCTs are needed to address biases and reinforce confidence in the findings.
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