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Postoperative pain tonsillectomy

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https://www.readbyqxmd.com/read/28328759/topical-ropivacaine-in-prevention-of-post-tonsillectomy-pain-in-adults
#1
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...
March 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#2
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...
March 18, 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
#3
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
#4
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...
March 18, 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
#5
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...
March 14, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28251321/comparing-the-effects-of-peritonsillar-infiltration-of-tramadol-before-and-after-the-surgery-on-post-tonsillectomy-pain
#6
Hatami Maryam, Jesmani Amin, Vaziribozorg Sedighe, Ayatollahi Vida
The aim of the study was to compare the effects of peritonsillar infiltration of tramadol before and after the surgery on post-tonsillectomy pain. In this double-blinded clinical trial study, 80 children aged 5-12 years old with ASA (American Society of Anesthesiologists) class I or II undergoing tonsillectomy involved. In group A (n = 40), after anesthesia induction and before starting the surgery, tramadol 2 mg/kg diluted in normal saline up to 2 cc total volume was injected into the tensile bed by the anesthesiologist using a 25 gauge needle...
March 1, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28213775/post-tonsillectomy-pain-after-using-bipolar-diathermy-scissors-or-the-harmonic-scalpel-a-randomised-blinded-study
#7
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
https://www.readbyqxmd.com/read/28070602/acupuncture-in-posttonsillectomy-pain-a%C3%A2-prospective-double-blinded-randomized-controlled-trial
#8
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
https://www.readbyqxmd.com/read/28012528/the-effect-of-iv-dexamethasone-versus-local-anesthetic-infiltration-technique-in-postoperative-nausea-and-vomiting-after-tonsillectomy-in-children-a-randomized-double-blind-clinical-trial
#9
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
https://www.readbyqxmd.com/read/28012511/the-use-of-the-flacc-pain-scale-in-pediatric-patients-undergoing-adenotonsillectomy
#10
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
https://www.readbyqxmd.com/read/27933348/-acupuncture-in-posttonsillectomy-pain-a%C3%A2-prospective-double-blind-randomized-controlled-trial-german-version
#11
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
https://www.readbyqxmd.com/read/27930564/effects-of-intraoperative-dexmedetomidine-with-intravenous-anesthesia-on-postoperative-emergence-agitation-delirium-in-pediatric-patients-undergoing-tonsillectomy-with-or-without-adenoidectomy-a-consort-prospective-randomized-controlled-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
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)
https://www.readbyqxmd.com/read/27863042/role-of-honey-after-tonsillectomy-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#13
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
https://www.readbyqxmd.com/read/27787936/magnesium-sulphate-for-postoperative-complications-in-children-undergoing-tonsillectomies-a-systematic-review-and-meta-analysis
#14
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
https://www.readbyqxmd.com/read/27779354/pharmacokinetics-and-analgesic-effectiveness-of-intravenous-parecoxib-for-tonsillectomy-%C3%A2-adenoidectomy
#15
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
https://www.readbyqxmd.com/read/27619026/the-comparison-of-bleeding-and-pain-after-tonsillectomy-in-bipolar-electrocautery-vs-cold-dissection
#16
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/27450664/postoperative-paediatric-pain-prevalence-a-retrospective-analysis-in-a-university-teaching-hospital
#17
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
https://www.readbyqxmd.com/read/27440142/safety-considerations-in-the-use-of-ketorolac-for-postoperative-pain
#18
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
https://www.readbyqxmd.com/read/27406705/effects-of-covering-surgical-wounds-with-polyglycolic-acid-sheets-for-posttonsillectomy-pain
#19
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
https://www.readbyqxmd.com/read/27357971/celecoxib-versus-placebo-in-tonsillectomy-a-prospective-randomized-double-blind-placebo-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
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
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