Topical sucralfate in post-adenotonsillectomy analgesia in children: a double-blind randomized clinical trial.
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.
Miura
Mauricio Schreiner
MS
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
Saleh
Catia
C
de Andrade
Marina
M
Assmann
Melina
M
Ayres
Marcio
M
Lubianca Neto
José Faibes
JF
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
D013392:Sucralfate