Pain management after tonsillectomy—by demand or by-the-clock—is there a difference?

Gostian M, Stilkerich L, Pauly A, Balk M, Rupp R, Allner M, Iro H, Gostian AO, Waldfahrer F (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Ent-Ear Nose & Throat Journal Mci Medquest Communications Inc

Abstract

Purpose: To improve pain management after tonsillectomy (TE) by comparing individual analgesic management by demand versus a fixed-scheduled analgesic treatment protocol in a prospective trial. Patients and Methods: Forty consecutive patients received individual pain treatment by demand (control group) followed by 40 patients who were treated by a fixed-scheduled four-staged escalating analgesic protocol (intervention group) after TE. Minimum and maximum pain as well as pain on ambulation (NRS 0-10) on the first postoperative day were defined as primary objectives. Secondary endpoints comprised the analgesic score, treatment-related side effects/pain-associated impairments, wish for more pain medication, and patient satisfaction. Patients were surveyed using the standardized and validated “Quality Improvement in Postoperative Pain Treatment” (QUIPS) questionnaire. Results: Patients of the control group reported comparable minimum (2.03 ± 1.42 vs 2.38 ± 1.79, P = 0.337, r = 0.110) and maximum pain (6.65 ± 2.10 vs 6.93 ± 1.86, P = 0.536, r = 0.07) and pain on ambulation (4.73 ± 2.26 vs 5.18 ± 2.19, P = 0.370, r = 0.10) compared to the intervention group. Patients in both groups were comparably well satisfied with the pain treatment (7.53 ± 2.40 vs 7.73 ± 2.30, P = 0.704, r = 0.04), experienced similar side effects and functional impairments (P > 0.050, Φ < 0.3), and did not ask for much more analgesic medication (P = 0.152, Φ = 0.160). Conclusion: Pain control following TE was not distinctly affected by applying a fixed-scheduled analgesic treatment protocol compared to individual analgesic therapy. In conclusion, analgesic treatment after TE remains unsatisfying. Consequently, further efforts are needed to achieve a standardized and effective approach to the underlying pathophysiological causes of pain following TE.

Authors with CRIS profile

Lisa Zieringer Medizinische Fakultät Anne Pauly Professur für Molekulare und Klinische Pharmazie Matthias Balk Department of Otorhinolaryngology – Head and Neck Surgery Robin Rupp Department of Otorhinolaryngology – Head and Neck Surgery Moritz Allner Department of Otorhinolaryngology – Head and Neck Surgery Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Antoniu-Oreste Gostian Department of Otorhinolaryngology – Head and Neck Surgery Frank Waldfahrer Department of Otorhinolaryngology – Head and Neck Surgery

Involved external institutions

Waldkrankenhaus St Marien

Germany (DE)

How to cite

APA:

Gostian, M., Stilkerich, L., Pauly, A., Balk, M., Rupp, R., Allner, M.,... Waldfahrer, F. (2022). Pain management after tonsillectomy—by demand or by-the-clock—is there a difference? Ent-Ear Nose & Throat Journal. https://doi.org/10.1177/01455613221116223

MLA:

Gostian, Magdalena, et al. "Pain management after tonsillectomy—by demand or by-the-clock—is there a difference?" Ent-Ear Nose & Throat Journal (2022).

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