title: Pre-emptive triple analgesia protocol for tonsillectomy pain control in children: double-blind, randomised, controlled, clinical trial.
abstract: BACKGROUND
  This double-blind, controlled, parallel-group study was designed to determine the efficacy of pre-emptive triple analgesia for paediatric post-tonsillectomy pain management.
  
  
  METHODS
  One hundred and thirty-five children were randomised into two groups: pre-emptive triple analgesia (n = 55) and control (n = 80). Pain was assessed using a visual analogue scale (in hospital) and the Parent's Postoperative Pain Measure (at home), and scores recorded.
  
  
  RESULTS
  Visual analogue scale scores on awakening and for 6 hours post-surgery were significantly better in the study group than the control group (p < 0.05). The Parent's Postoperative Pain Measure scores of control group children were significantly higher within the first 3 post-operative days (p = 0.000), with a greater percentage of children experiencing significant pain and requiring more analgesia.
  
  
  CONCLUSIONS
  The proposed multimodal, pre-emptive analgesia protocol for paediatric post-tonsillectomy pain results in less post-operative pain, both in hospital or at home.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Mansoura University, Egypt. ahmusaad@mans.edu.eg
authors.forename: A M A
authors.initials: AM
authors.lastname: El-Fattah
authors.forename: E
authors.initials: E
authors.lastname: Ramzy
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000779:Anesthetics, Local; D002648:Child; D002675:Child, Preschool; D004008:Diclofenac / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D014068:Tonsillectomy; D014147:Tramadol / Q000627:therapeutic use
chemical_list: D000779:Anesthetics, Local; D004008:Diclofenac; D000082:Acetaminophen; D014147:Tramadol