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Postoperative pain tonsillectomy

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https://www.readbyqxmd.com/read/28719708/plasmablade-vs-cold-dissection-tonsillectomy-a-prospective-randomized-double-blind-controlled-study-in-adults
#1
Rasim Yilmazer, Zahide Mine Yazici, Meliksah Balta, Ibrahim Erdim, Omer Erdur, Fatma Tulin Kayhan
We conducted a prospective, randomized, double-blind, controlled clinical study to compare the efficacy and safety of the PlasmaBlade device and cold dissection for adult tonsillectomy. Our study group was made up of 20 patients-12 men and 8 women, aged 18 to 50 years (mean: 27.1)-who were undergoing a bilateral tonsillectomy. Each patient had one randomly chosen tonsil removed by the PlasmaBlade and the other by cold instrumentation. We compared the duration of surgery, the amount of intraoperative blood loss, the number of sutures required, the status of tonsillar fossa wound healing at 7 and 14 days postoperatively, the amount of postoperative pain, and postoperative complications...
July 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28669256/pediatric-coblation-total-tonsillectomy-intracapsular-or-extracapsular
#2
Ying-Xia Lu, Qing-Long Gu, Zhan Wang, Bing Zhang, Chang Liu, Jie-Qiong Liang
OBJECTIVES: To compare the results of coblation intracapsular total tonsillectomy (CITT) with those of conventional coblation extracapsular total tonsillectomy (CETT) in the treatment of tonsillar hypertrophy in children with regards to efficacy and complications. METHODS: Ninety children with adenotonsillar hyperplasia underwent tonsillectomy ± adenoidectomy (48 CITT and 42 CETT). Intraoperative situation was observed and recorded. Patients were reexamined regarding recovery condition and tonsil regrowth, and were followed for at least one year...
July 2, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28662233/control-of-pain-after-tonsillectomy-in-children-a-review
#3
Grace X Tan, David E Tunkel
Importance: The relief of pain after tonsillectomy in children remains challenging and even controversial. While the need for pain control after this surgery is understood, recent debate has centered around the risks of opioids in children with obstructive sleep apnea syndrome (OSAS) and the possible increases in posttonsillectomy hemorrhage with the use of alternative nonsteroidal anti-inflammatory drugs (NSAIDs). Observations: We discuss the multiple facets of posttonsillectomy pain control in children...
June 29, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28614221/correlation-of-mdr1-gene-polymorphisms-with-anesthetic-effect-of-sevoflurane-remifentanil-following-pediatric-tonsillectomy
#4
Nian-Jun Shi, Wei-Xia Zhang, Ning Zhang, Li-Na Zhong, Ling-Ping Wang
BACKGROUND: The motive of this study was to investigate the collaboration between MDR1 gene polymorphisms and anesthetic effects following pediatric tonsillectomy. METHODS: All together 178 children undergoing tonsillectomy with preoperative sevoflurane-remifentanil anesthesia were selected. In order to determine MDR1 gene polymorphisms of 3435C > T, 1236C > T, and 2677G > T/A, polymerase chain reaction-restriction fragment length polymorphism was used...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28608417/otolaryngology-practice-patterns-in-pediatric-tonsillectomy-the-impact-of-the-codeine-boxed-warning
#5
Julie L Goldman, Craig Ziegler, Elizabeth M Burckardt
OBJECTIVES/HYPOTHESIS: To determine if otolaryngologists at a single children's hospital were adherent to the boxed warning for codeine use in post-tonsillectomy patients and the implications for practice patterns. STUDY DESIGN: Case series with chart review. METHODS: Charts from all patients undergoing adenotonsillectomy at a single children's hospital from January 1, 2010 through December 31, 2015 were analyzed and stratified according to date (pre- or post-boxed warning) and practitioner type (academic otolaryngologists [AO] vs...
June 13, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28607888/postoperative-pain-in-adult-tonsillectomy-is-there-any-difference-between-the-technique
#6
Itziar Álvarez Palacios, Ricardo González-Orús Álvarez-Morujo, Cristina Alonso Martínez, Alejandra Ayala Mejías, Oscar Arenas Brítez
Tonsillectomy is one of the most common surgical procedures performed worldwide. Several techniques have been developed to reduce morbidity and enhance recovery after tonsillectomy. Our study was designed to compare post-operative pain with three different techniques: cold dissection (CD), monopolar-bipolar dissection (MBD) and coblation dissection (CBD). 103 adults were scheduled for elective tonsillectomy from September 2014 to December 2015, and were randomized to CD, MBD and CBD. Post-operative pain was assessed using visual analogue scale (VAS) and Lattinen Test (LT)...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28530254/palatal-surgery-in-a-transoral-robotic-setting-tors-preliminary-results-of-a-retrospective-comparison-between-uvulopalatopharyngoplasty-uppp-expansion-sphincter-pharyngoplasty-esp-and-barbed-repositioning-pharyngoplasty-brp
#7
G Cammaroto, F Montevecchi, G D'Agostino, E Zeccardo, C Bellini, G Meccariello, C Vicini
It has become increasingly clear in the past decade that surgical management of obstructive sleep apnoea hypopnoea syndrome (OSAHS) is most successfully managed with multilevel surgery. We evaluated the outcomes of multilevel interventions comparing three different palatal techniques added to TORS: uvulopalatopharyngoplasty (UPPP), a modified expansion sphincter pharyngoplasty (ESP), inspired by the Pang expansion sphincter pharyngoplasty technique and the latest barbed repositioning pharyngoplasty (BRP). Thirty patients were retrospectively evaluated...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28489244/role-of-intraoperative-ropivacaine-in-adult-post-tonsillectomy-pain-control-a-randomized-controlled-trial
#8
William C Yao, Christian A Corbitt, Masayoshi Takashima
We sought to evaluate the efficacy of ropivacaine in post-tonsillectomy pain management in adults and evaluate the timing of intraoperative ropivacaine administration for this purpose. A prospective, double-blinded, randomized, controlled trial with a paired design was performed in 25 consecutive adults undergoing tonsillectomy. To date, no studies examining the efficacy of local anesthetics in post-tonsillectomy pain control have used a paired design to account for the variability in pain difference between individuals...
April 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28489240/the-role-of-hypertonic-saline-in-monopolar-tonsillectomy-in-adult-patients
#9
Jian Ma, Mei Zheng, Jun-Wei Mu, Peng Cui
This study's objective was to look for a simple and inexpensive method to reduce patients' pain during tonsillectomy. Bilateral tonsillectomy patients were enrolled and placed into different groups based on their admission numbers. Patients with odd numbers had electrical tonsillectomy on the right side with hypertonic saline injection into the tonsillar capsule (group A) or electrical tonsillectomy on the left side with normal saline injection (group B). Those with even numbers had electrical tonsillectomy on the left side with hypertonic saline injection into the tonsillar capsule (group A) or electrical tonsillectomy on the right side with normal saline injection (group B)...
April 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28472239/association-between-ibuprofen-use-and-severity-of-surgically-managed-posttonsillectomy-hemorrhage
#10
Pamela A Mudd, Princy Thottathil, Terri Giordano, Ralph F Wetmore, Lisa Elden, Abbas F Jawad, Luis Ahumada, Jorge A Gálvez
Importance: Ibuprofen used in postoperative management of pain after tonsillectomy has not been shown to increase the overall risk for posttonsillectomy hemorrhage (PTH). The severity of bleeding is difficult to quantify but may be a more important outcome to measure. Objective: To evaluate the association between ibuprofen use and severity of PTH using transfusion events as a marker of severity. Design, Setting, and Participants: This retrospective cohort study identified 8868 patients who underwent tonsillectomy from January 20, 2011, through June 30, 2014, at the tertiary academic Children's Hospital of Philadelphia...
July 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28470102/oct1-genetic-variants-are-associated-with-postoperative-morphine-related-adverse-effects-in-children
#11
Rajiv Balyan, Xue Zhang, Vidya Chidambaran, Lisa J Martin, Tomoyuki Mizuno, Tsuyoshi Fukuda, Alexander A Vinks, Senthilkumar Sadhasivam
AIM: Large interindividual variability in morphine pharmacokinetics (PK) could contribute to variability in morphine analgesia and adverse events. Respiratory depression (RD) and postoperative nausea and vomiting (PONV) are significant adverse drug response of intravenous morphine in the perioperative setting limiting its efficacy in achieving adequate surgical pain relief. OCT1 is a transporter in the liver that transports morphine from the bloodstream into hepatocytes. Earlier we reported association of genetic polymorphisms in OCT1 with morphine PK, and lower morphine clearance in Caucasian children as compared with African-American (AA) children...
May 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28442950/effect-of-intranasal-dexmedetomidine-on-emergence-agitation-after-sevoflurane-anesthesia-in-children-undergoing-tonsillectomy-and-or-adenoidectomy
#12
Ahmed Mostafa Abd El-Hamid, Hany Mahmoud Yassin
BACKGROUND: Emergence agitation (EA) after sevoflurane anesthesia is common in children during recovery from general anesthesia and may result in postoperative complications. This study investigated safety and effectiveness of intranasal dexmedetomidine in reducing the incidence and severity of EA. METHODS: This prospective, randomized double-blinded controlled trial included 86 patients scheduled for the tonsillectomy and/or adenoidectomy under general anesthesia with sevoflurane...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28417665/can-intracapsular-tonsillectomy-be-an-alternative-to-classical-tonsillectomy-a-meta-analysis
#13
Jong Seung Kim, Sam Hyun Kwon, Eun Jung Lee, Yong Joo Yoon
Objective Tonsillectomy is the most common operation performed in the otolaryngologic fields. Efforts have been made to reduce postoperative complications, and one of these is intracapsular tonsillectomy and adenoidectomy (ICTA), which leaves the tonsillar tissue with tonsillar capsule. This study aimed to evaluate intracapsular tonsillectomy compared with classical extracapsular tonsillectomy in terms of efficacy of the technique for managing obstructive sleep apnea (OSA) and reducing postoperative complications...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28409242/comparison-of-topical-ropivacaine-with-and-without-ketamine-on-post-surgical-pain-in-children-undergoing-tonsillectomy-a-randomized-controlled-double-blind-study
#14
Boohwi Hong, Chae Seong Lim, Yoon-Hee Kim, Jung Un Lee, Yong Min Kim, Choonho Jung, Yumin Jo
PURPOSE: Tonsillectomy in pediatric patients may cause severe postoperative pain. Topical local anesthetics are an easy and safe way to control post-tonsillectomy pain, but there is no benefit during the early postoperative stage. Topical ketamine shows a good effect on early stage postoperative pain. We compared the effect of topical ropivacaine with and without ketamine on post-tonsillectomy pain. METHODS: Patients aged 3-7 years undergoing tonsillectomy were selected to participate in the study...
August 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28364572/comparison-of-cold-technique-tonsillectomy-and-thermal-welding-tonsillectomy-at-different-age-groups
#15
COMPARATIVE STUDY
Arif Sanlı, Gazi Yildiz, Banu Atalay Erdogan, Mustafa Paksoy, Gokhan Altin, Muhammed Ali Ozcelik
The aim of this study is to compare objectively advantages and disadvantages of cold technique tonsillectomy and thermal welding tonsillectomy at the same case. A total of 100 patients, 53 patients younger than 12 years of age and 47 patients elder than 12 years of age, were included in this study. Tonsillectomy was performed by using cold technique on the right side of the palatine tonsils and thermal welding on the left side. Right and left sides were compared regarding perioperative bleeding, surgical dissection time, postoperative pain scale at the 1st and 7th day and postoperative bleeding parameters...
2017: Prague Medical Report
https://www.readbyqxmd.com/read/28328759/topical-ropivacaine-in-prevention-of-post-tonsillectomy-pain-in-adults
#16
Hanna Kaisa Tolska, Annika Takala, Karin Blomgren, Katri Hamunen, Vesa Kontinen
BACKGROUND: Post-tonsillectomy pain is 1 of the most intense postoperative pain conditions. However, optimal and sufficient postoperative analgesic treatment remains unclear. We investigated the effect of topical ropivacaine for post-tonsillectomy pain in 160 adult outpatient surgery patients over 2 postoperative weeks. METHODS: At the end of tonsillectomy, 2 swabs soaked in either 1% ropivacaine or saline were packed into the tonsillar beds for 5 minutes. We used ibuprofen and a combination of acetaminophen (500 mg)-codeine (30 mg) tablets as postoperative analgesics for 2 weeks...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#17
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28320603/influence-of-dietary-and-physical-activity-restriction-on-pediatric-adenotonsillectomy-postoperative-care-in-brazil-a-randomized-clinical-trial
#18
Denise Manica, Leo Sekine, Larissa S Abreu, Michelle Manzini, Luísi Rabaioli, Marcel M Valério, Manoela P Oliveira, João A Bergamaschi, Luciano A Fernandes, Gabriel Kuhl, Cláudia Schweiger
INTRODUCTION: Although culturally food and physical activity restriction are part of the routine postoperative care of many Brazilian surgeons, current evidences from other countries support no such recommendations. OBJECTIVE: To determine whether dietary and physical restriction effectively lead to a decrease on postoperative complications of adenotonsillectomy in children when compared to no restriction. METHODS: We have designed a randomized clinical trial comparing two intervention: no specific counseling on diet or activity (Group A), and restriction recommendations on diet and physical activities (Group B)...
February 22, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28315933/coblation-tonsillectomy-a-systematic-review-and-descriptive-analysis
#19
Christopher Metcalfe, Jameel Muzaffar, Charles Daultrey, Christopher Coulson
Coblation is one of the more recent techniques for tonsillectomy; however, it remains unclear whether it exhibits any benefit or increased risk when compared to other techniques. This review provides an updated assessment of coblation tonsillectomy and how it compares to other tonsillectomy techniques. Systematic review and descriptive analysis of published literature. Electronic searches of MEDLINE, EMBASE, Web of Science and the Cochrane Database were performed. We included all randomized control trials comparing coblation tonsillectomy (not 'tonsillotomy') with any other tonsillectomy technique...
June 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28289832/indirect-costs-related-to-caregivers-absence-from-work-after-paediatric-tonsil-surgery
#20
Gunnhildur Gudnadottir, G Ragnarson Tennvall, J Stalfors, J Hellgren
Tonsillotomy has gradually replaced tonsillectomy as the surgical method of choice in children with upper airway obstruction during sleep, because of less postoperative pain and a shorter recovery time. The aim of this study was to examine the costs related to caregivers' absenteeism from work after tonsillectomy (TE) and tonsillotomy (TT). All tonsillectomies and tonsillotomies in Sweden due to upper airway obstruction during 1 year, reported to the National Tonsil Surgery Register in children aged 1-11 were included, n = 4534...
June 2017: European Archives of Oto-rhino-laryngology
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