title: Comparison of two analgesic protocols for post-tonsillectomy pain control in outpatient adults.
abstract: OBJECTIVE
  Tonsillectomy causes a moderate to severe postoperative pain, and its treatment is an unsolved problem. The objective of this study was to compare the effectiveness of 2 analgesic protocols and their related complications.
  
  
  METHODS
  Two groups of adult patients submitted to ambulatory tonsillectomy were studied. In group 1, 52 patients received a combination of tramadol and NSAIDs postoperatively; in group 2, 60 patients were treated with prednisone and NSAIDs. Two surgical techniques were used: cold dissection or dissection with electrocautery. Pain was recorded on days 4, 7 and 15, using a numerical scale from 0 to 10.
  
  
  RESULTS
  Both groups showed similar pain at postoperative day 4. At day 7, pain was higher in group 2 (P=.049), while at day 15 both groups showed only some discomfort. Sickness and vomiting was more frequent in group 1, and haemorrhage and hospitalisation in group 2. Cold dissection patients showed lower levels of pain at days 4 and 7, independently of analgesic protocol, and had lower haemorrhage and emergency visit rates.
  
  
  CONCLUSIONS
  The efficacy of both protocols was similar in terms of control of pain, with the exception of day 7; however, the protocol with prednisone showed fewer secondary effects. Patients operated using cold dissection had less pain and fewer complications.
authors: Unidad de Cirugía Mayor Ambulatoria, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España. Electronic address: luzcolloto@gmail.com.
authors: María Luz
authors: ML
authors: Magdalena
authors: Unidad de Cirugía Mayor Ambulatoria, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España.
authors: Luisa
authors: L
authors: Caragol
authors: Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España.
authors: Antonio
authors: A
authors: Solé
authors: Unidad de Cirugía Mayor Ambulatoria, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España.
authors: Juan Pablo
authors: JP
authors: Rodrigo
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002985:Clinical Protocols; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011241:Prednisone / Q000008:administration & dosage*; D011446:Prospective Studies; D014068:Tonsillectomy; D014147:Tramadol / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D014147:Tramadol; D011241:Prednisone
keywords: Amigdalectomía; Complicaciones postoperatorias; Dolor postoperatorio; Enfermería; Nursing; Postoperative complications; Postoperative pain; Prednisona; Prednisone; Tonsillectomy; Tramadol