title: Topical sucralfate in post-adenotonsillectomy analgesia in children: a double-blind randomized clinical trial.
abstract: OBJECTIVE
  Tonsillectomy, with or without adenoidectomy, is one of the most common surgical procedures in pediatric otolaryngology. Despite its relative simplicity, pain is the main cause of morbidity in the postoperative period. We determined the effect of topical sucralfate on reduction of oropharyngeal pain in children submitted to adenotonsillectomy. Secondary outcomes were otalgia, analgesic use, type of diet, secondary bleeding, vomiting, fever, and weight loss.
  
  
  METHODS
  Double-blind, randomized clinical trial.
  
  
  METHODS
  Tertiary hospital.
  
  
  METHODS
  Eighty-two children of both sexes between four and 12 years old submitted to adenotonsillectomy were evaluated. They were allocated to receive topical sucralfate or placebo in intraoperative and postoperative periods four times a day for five days. Pain was measured through faces pain scale.
  
  
  RESULTS
  Reduction in oropharyngeal pain was significant with use of sucralfate during five days of evaluation (mean, 95% confidence interval, and P value); day 1: 2.05, 1.53-2.58, P = 0.000; day 2: 2.1, 1.51-2.70, P = 0.001; day 3: 1.44, 0.88-1.99, P = 0.003; day 4: 1.13, 0.58-1.55, P = 0.027; day 5: 0.67, 0.26-1.04, P = 0.021). There was no difference in secondary outcomes.
  
  
  CONCLUSIONS
  We found beneficial effect of use of sucralfate in reduction of oropharyngeal pain in the postoperative period of adenotonsillectomy. However, topical sucralfate does not have a potent effect to the point of being utilized as a single analgesic treatment. Because it is simple, safe, tolerated, and low-cost, it is an important tool as adjuvant treatment of post-tonsillectomy pain.
authors.affiliation: Department of Medical Surgery of Universidade Federal de Ciências da Saúde de Porto Alegre and Division of Pediatric Otorhinolaryngology at Hospital da Criança Santo Antênio, Programa de Pós-Graduação em Ciências Médicas-Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. mmiura.voy@terra.com.br
authors.forename: Mauricio Schreiner
authors.initials: MS
authors.lastname: Miura
authors.forename: Catia
authors.initials: C
authors.lastname: Saleh
authors.forename: Marina
authors.initials: M
authors.lastname: de Andrade
authors.forename: Melina
authors.initials: M
authors.lastname: Assmann
authors.forename: Marcio
authors.initials: M
authors.lastname: Ayres
authors.forename: José Faibes
authors.initials: JF
authors.lastname: Lubianca Neto
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000287:Administration, Topical; D000698:Analgesia / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010608:Pharyngeal Diseases / Q000601:surgery*; D013392:Sucralfate / Q000008:administration & dosage*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D013392:Sucralfate