[Treatment of pain in patients after tonsillectomy].

The aim of the study was to evaluate post-operative pain in patients after tonsillectomy, treated with non-steroid anti-inflammatory and opioid drugs. A group of 57 patients aged from 16 to 53 years was examined. 32 of them were treated with ketoprofen (Ketonal, Lek) in a dose 100 mg, 3 times a day and the remaining 25 with tramadol hydrochloride (Tramal) in daily doses 150-200 mg. The numerical 0 to 10 (VAS) and 6-grade verbal scales were used to assess pain intensity. Pain intensity was highest 3-4 days after tonsillectomy. The scores below 5 points (VAS) were noted by 65% of patients treated with ketoprofen and 90% of patients treated with tramadol after the first 24 postoperative hours. The pain reacted relatively well to oral analgesics and did not require prolonged hospitalisation. A double mechanism of reducing pain by tramadol--central and spinal--may be more effective in patients after tonsillectomy than ketoprofen that blocks production of arachidonic acid cascade. In the course of the first few postoperative days, inflammation is aggravated due to infection of the wound in the throat and the latter mechanism alone may be insufficient. Effectiveness of either ketoprofen or tramadol in treatment of post-tonsillectomy pain is good but better in the case of tramadol. Patients must be informed in advance about a possibility of more intense pain a few days after tonsillectomy, in order to avoid unjustified fear.