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Postoperative pain tonsillectomy

Linn Arbin, Mats Enlund, Johan Knutsson
OBJECTIVE: To compare the postoperative pain following bipolar diathermy scissors tonsillectomy (higher temperature dissection) with harmonic scalpel tonsillectomy (lower temperature dissection). METHODS: Sixty patients aged 7-40 years planned for tonsillectomy with no other concurrent surgery were randomised to either bipolar diathermy scissors or harmonic scalpel as surgical technique. Blinded to the surgical technique, the patients recorded their pain scores (VAS, 0-10) at awakening and the worst pain level of the day in the postoperative period...
February 17, 2017: European Archives of Oto-rhino-laryngology
J Dingemann, B Plewig, I Baumann, P K Plinkert, S Sertel
BACKGROUND: Postoperative swallowing pain is one of the most unpleasant after-effects of tonsillectomy. During recent years, the demand for alternatives to drug-based pain therapy has continued to grow, although the topic has received little research attention until now. MATERIALS AND METHODS: A total of 46 patients were randomized into verum acupuncture, control acupuncture, and drug-based treatment groups. All patients received nonsteroidal antirheumatic drugs (NSAIDs)...
January 2017: HNO
Zoher Naja, Saleh Kanawati, Rania Al Khatib, Fouad Ziade, Zeina Z Naja, Ahmad Salah Naja, Mariam Rajab
BACKGROUND: Local anesthetic infiltration and corticosteroids had shown effectiveness in reducing post tonsillectomy nausea, vomiting and pain. OBJECTIVES: To compare the effect of intravenous dexamethasone versus pre-incision infiltration of local anesthesia in pediatric tonsillectomy on postoperative nausea and vomiting (PONV). The secondary objective was postoperative pain. METHODS: A randomized double-blind clinical trial was conducted at a tertiary care teaching hospital...
January 2017: International Journal of Pediatric Otorhinolaryngology
Andrew J Redmann, Yu Wang, James Furstein, Charles M Myer, Alessandro de Alarcón
OBJECTIVES: 1) Determine the usage rate of opioid pain medication after adenotonsillectomy (T&A). 2) Review the use of the Face, Legs, Activity, Cry, Consolability (FLACC) pain scale for T&A patients 3) Determine the rate of postoperative physician contacts for pain related complaints. METHODS: A retrospective case series review was performed on 125 pediatric patients undergoing T&A and subsequent 23-hour postoperative observation at an academic tertiary care center from June-August of 2015...
January 2017: International Journal of Pediatric Otorhinolaryngology
J Dingemann, B Plewig, I Baumann, P K Plinkert, S Sertel
BACKGROUND: Postoperative swallowing pain is one of the most unpleasant after-effects of tonsillectomy. During recent years, the demand for alternatives to drug-based pain therapy has continued to grow, although the topic has received little research attention until now. MATERIALS AND METHODS: A total of 46 patients were randomized into verum acupuncture, control acupuncture, and drug-based treatment groups. All patients received nonsteroidal antirheumatic drugs (NSAIDs)...
December 8, 2016: HNO
Jun-Li Cao, Yu-Ping Pei, Jing-Qiu Wei, Yue-Ying Zhang
Postoperative emergence agitation/delirium (POED) is a common complication in pediatric surgery patients, which increases the risk of developing postoperative airway obstruction and respiratory depression. This study aims to investigate the safety and efficacy of intraoperative infusion of dexmedetomidine (DEX) and its effects on POED in pediatric patients undergoing tonsillectomy with or without adenoidectomy.Sixty patients scheduled for tonsillectomy with or without adenoidectomy, aged 2 to 8 years, were randomly allocated into 2 groups (n = 30)...
December 2016: Medicine (Baltimore)
A Lal, K Chohan, A Chohan, A Chakravarti
BACKGROUND: Honey reduced post-tonsillectomy pain, but its effects on awakening at night, inflammation and healing of the tonsillar fossa were controversial. OBJECTIVES: This systematic review and meta-analysis of randomised controlled trials (RCTs) evaluated the effect of oral honey on pain, consumption of painkillers, awakening at night, healing of tonsillar fossa and adverse effects in children after tonsillectomy. METHODS: A search of MEDLINE, EMBASE, Scopus, CINAHL and Cochrane Collaboration Library databases was performed without any restriction of publication year...
November 12, 2016: Clinical Otolaryngology
Xie Min, L I Xiang-Kui, Peng Yu
OBJECTIVE: Previous systematical reviews showed that systemic magnesium decreased postoperative pain and reduced morphine use without any reported serious adverse effects in adults. However studies in children yielded different results. So we conducted a systematic review to evaluate the impact of magnesium sulphate on postoperative complications in Children undergoing tonsillectomies. METHODS: The PubMed, EMbase via OVID, CENTRAL, WHO ICTRP were searched to identify randomized controlled trials (RCTs) that addressed the effect of magnesium for postoperative pain, agitation and complications in children undergoing tonsillectomies...
September 8, 2016: Journal of Evidence-based Medicine
Lena Tan, Elsa Taylor, Jacqueline A Hannam, Lesley Salkeld, Sam Salman, Brian J Anderson
BACKGROUND: Few pharmacokinetic (PK) and pharmacodynamic (PD) data exist for COX-2 selective inhibitors in children. We wished to characterize the PKPD of parecoxib and its active metabolite, valdecoxib, in this population. METHODS: Children (n = 59) were randomized to parecoxib 0.25 mg·kg(-1) , 1 mg·kg(-1) , and 2 mg·kg(-1) during tonsillectomy ± adenoidectomy. Samples (4-6 per child) were obtained from indwelling cannula over 6 h. A second group of inpatient children (n = 15) given 1 mg·kg(-1) contributed PK data from 6 to 24 h...
December 2016: Paediatric Anaesthesia
Mohammad Hossein Dadgarnia, Mohammad Ali Aghaei, Saeid Atighechi, Nasim Behniafard, Mohammad Reza Vahidi, Mojtaba Meybodian, Vahid Zand, Maryam Vajihinejad, Abdollah Ansari
OBJECTIVE: Although tonsillectomy is one of the most common surgeries performed in pediatric, it has potential major complications such as pain and bleeding. This study aimed to compare the bleeding and pain after tonsillectomy in bipolar electrocautery tonsillectomy versus cold dissection. METHODS: This double blind clinical trial was conducted on 70 pediatric patients who were candidate of tonsillectomy. Patients were divided into two groups of including bipolar cautery (BC) and cold dissection (CD)...
October 2016: International Journal of Pediatric Otorhinolaryngology
Alexander Avian, Brigitte Messerer, Gerit Wünsch, Annelie Weinberg, Andreas Sandner Kiesling, Andrea Berghold
BACKGROUND: Overall pain prevalence in paediatric patients is well documented, but relatively little attention has been paid to pain prevalence and intensity on specific postoperative days within the first week following an operation. OBJECTIVES: To evaluate reported pain prevalence on the day of surgery and each day during the following week and to analyse pain trajectories. DESIGN: Retrospective study. SETTING: Single centre university hospital...
October 2016: International Journal of Nursing Studies
Benjamin Maslin, Lawrence Lipana, Brandon Roth, Gopal Kodumudi, Nalini Vadivelu
BACKGROUND: Ketorolac use has significantly expanded for postoperative pain management since it first became available in the United States, primarily due to well established effects on patient pain scores and its ability to reduce perioperative opioid requirements. As an inhibitor of cyclooxygenase, ketorolac use has raised clinical concern including particular controversy regarding its potential effects on bone healing, postoperative kidney function and perioperative bleeding. OBJECTIVE: To review the supporting data from clinical studies addressing the safety of ketorolac use for postoperative pain...
July 19, 2016: Current Drug Safety
Shin-Ichi Miyaguchi, Arata Horii, Rumi Kambara, Norihiko Takemoto, Hitoshi Akazawa, Nao Takahashi, Hironori Baba, Hidenori Inohara
Postoperative pain is a remaining issue in tonsillectomy. Polyglycolic acid (PGA) is a biocompatible material used for absorbent suture reinforcement, and its sheet has been applied for covering defects after resection of oral carcinoma. The aim of this study is to examine whether the attachment of a PGA sheet to surgical wounds would reduce posttonsillectomy pain. In this prospective single-blind study, 17 consecutive adult patients were recruited who needed to undergo tonsillectomy, mainly due to habitual tonsillitis...
July 12, 2016: Otolaryngology—Head and Neck Surgery
Douglas J Van Daele, Kellie L Bodeker, Douglas K Trask
OBJECTIVES: Celecoxib is a cyclooxygenase-2-specific inhibitor indicated to treat acute pain and pain secondary to osteoarthritis and rheumatoid arthritis. Surgical models of acute pain have demonstrated superior pain relief to placebo. The objective of this study was to test the safety and efficacy of celecoxib for pain relief after tonsillectomy compared to placebo. METHODS: Adult subjects were randomized to 200 mg celecoxib versus placebo with a loading dose the night before surgery then twice daily for 10 days...
October 2016: Annals of Otology, Rhinology, and Laryngology
Julie Longard, Alison Twycross, Anna M Williams, Paul Hong, Jill Chorney
AIMS AND OBJECTIVES: To understand parents' experiences of managing their child's postoperative pain at home. BACKGROUND: Recent changes in children's health care services often shift the responsibility of managing children's postoperative pain to parents. Although pain management is important for good postoperative outcomes, it can be a challenging task for families, and children's pain is often under-managed. DESIGN: This qualitative study used semi-structured interviews to explore parents' experiences of managing their child's postoperative pain at home...
September 2016: Journal of Clinical Nursing
Roseann S Gammal, Kristine R Crews, Cyrine E Haidar, James M Hoffman, Donald K Baker, Patricia J Barker, Jeremie H Estepp, Deqing Pei, Ulrich Broeckel, Winfred Wang, Mitchell J Weiss, Mary V Relling, Jane Hankins
After postoperative deaths in children who were prescribed codeine, several pediatric hospitals have removed it from their formularies. These deaths were attributed to atypical cytochrome P450 2D6 (CYP2D6) pharmacogenetics, which is also implicated in poor analgesic response. Because codeine is often prescribed to patients with sickle cell disease and is now the only Schedule III opioid analgesic in the United States, we implemented a precision medicine approach to safely maintain codeine as an option for pain control...
July 2016: Pediatrics
Seham M Moeen
BACKGROUND: Usage of nonpharmacological treatment contributes to an overall patient well-being, assisting in physical and emotional healing. Acupuncture has been reported to be useful in reducing early postoperative vomiting (POV) and attenuating postoperative pain. AIM: The aim of this study was to compare the effect of dexamethasone vs acupuncture at P6 bilaterally and CV13 on the incidence and severity of POV in children undergoing tonsillectomy with or without adenoidectomy...
August 2016: Paediatric Anaesthesia
Francisca Fuentealba Cargill, Leandro Biagini Alarcón
BACKGROUND: There is evidence that acupuncture may relieve pain. AIM: To assess the evidence about the effectiveness of acupuncture to relieve postoperative pain. MATERIAL AND METHODS: A systematic review of the literature selecting controlled clinical trials and systematic reviews comparing acupuncture with standard pain management. The value and quality of reports were evaluated using Jadad scale and STRICTA protocol. Pain intensity and analgesic consumption were the primary endpoints sought...
March 2016: Revista Médica de Chile
V Ayatollahi, S Dehghanpour Farashah, S Behdad, S Vaziribozorg, M Rabbani Anari
BACKGROUND: Postoperative pain is a common problem in hospitals. Adults undergoing uvulopalatopharyngoplasty (UPPP) with tonsillectomy experience an unacceptable level of intense postoperative pain, especially during the first 24 h after surgery. This study investigated the analgesic effects of vitamin C in patients undergoing UPPP and tonsillectomy. METHOD: This study was done on forty patients that were evaluated in a randomised double-blinded clinical trial. Patients included in the study were within the age range of 25-50 years with BMI<35, physical status I,II according to the American Society of Anesthesia (ASA) and who underwent uvulopalatopharyngoplasty and tonsillectomy...
February 2017: Clinical Otolaryngology
Yufeng Pang, Jingrong Gong, Juan Huang, Shuangzhu He, Hong Zhou
OBJECTIVE: A retrospective study to compare surgical parameters and postoperative pain in patients undergoing coblation tonsillectomy with or without microscopic guidance. METHODS: Data regarding duration of surgery and hospital stay, intraoperative blood loss, incidence of haemorrhage and postoperative pain scores were retrieved from the medical records of adult patients undergoing coblation tonsillectomy under direct vision or with microscopic guidance. RESULTS: The incidence of secondary haemorrhage (>24 h postoperatively) was significantly lower and the duration of hospital stay was significantly shorter in the microscope group (n = 92) than the direct vision group (n = 76)...
August 2016: Journal of International Medical Research
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