title: Topical application of ethanol to the tonsillar bed immediately following tonsillectomy does not improve post-operative analgesia.
abstract: Tonsillectomy is a painful procedure with discomfort continuing for days after the operation. We investigated whether topical application of a neurolytic agent (ethanol) to the tonsillar bed following dissection could provide long-term analgesia. Sixty-four patients undergoing tonsillectomy were randomized using matched pairs, to receive topical ethanol applied to the operative site, or saline for three min, in a double-blind study. Endpoints included self-reported pain using a pictorial pain scale, analgesia consumption adjusted for body mass, and weight loss. Follow-up continued until day 7 post-operatively. Both groups received the same analgesic protocol including infiltration of the operative site with ropivacaine. There were no significant differences in pain scores, analgesia requirements or weight loss between groups for any time period. The incidence of severe pain was significantly greater on the third post-operative day compared with day 1 and 2 (p = 0.0096). Topical application of ethanol does not reduce post-operative pain.
authors.affiliation: Department of Surgery, Northpark Private Hospital, Bundoora, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Purser
authors.forename: C F
authors.initials: CF
authors.lastname: Royse
authors.forename: H A
authors.initials: HA
authors.lastname: Velkov
authors.forename: L F
authors.initials: LF
authors.lastname: Roberts
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D002492:Central Nervous System Depressants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D000700:Analgesics; D002492:Central Nervous System Depressants; D000431:Ethanol