title: Effect of cold-water cooling of tonsillar fossa and pharyngeal mucosa on post-tonsillectomy pain.
abstract: OBJECTIVE
  Post-tonsillectomy pain is a notable concern and thermal injury produced by electric surgical devices is considered a main cause. Intraoperative cooling of the tonsillar fossa and pharyngeal mucosa with cold water has effectively reduced postoperative pain, but no studies have fully evaluated the effects of this technique with a proper study design. We assessed mucosal cooling in two groups of patients undergoing the same surgical technique by a single surgeon, with one group receiving cold-water cooling and the other group as a control.
  
  
  METHODS
  Forty patients who underwent monopolar electrocautery tonsillectomy were randomly assigned to two groups (n = 20 for each group). Group 1 received cooling of the tonsillar fossa and pharyngeal mucosa with 4 °C saline just after removal of each tonsil whereas Group 2 did not receive cooling. Postoperative pain was recorded on operation day and 1, 2, 4, 7, and 10 days postoperatively. Post-tonsillectomy pain, return to normal diet, and incidence of postoperative bleeding were compared between the groups.
  
  
  RESULTS
  Post-tonsillectomy pain on 6 selected days and overall pain during the 10-day follow-up period were significantly lower in Group 1. However, return to normal diet and incidence of postoperative bleeding did not differ significantly between the groups.
  
  
  CONCLUSIONS
  Intraoperative application of cold water after tonsillectomy significantly reduced postoperative pain. We recommend cooling the tonsillar fossa and pharyngeal mucosa with cold water during tonsillectomy to easily and effectively reduce post-tonsillectomy pain.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, South Korea.
authors: Jae Min
authors: JM
authors: Shin
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, South Korea.
authors: Jang Yul
authors: JY
authors: Byun
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea.
authors: Byoung Joon
authors: BJ
authors: Baek
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, South Korea. Electronic address: jyent@schmc.ac.kr.
authors: Jae Yong
authors: JY
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D003080:Cold Temperature; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*; D014066:Palatine Tonsil; D010614:Pharynx; D011446:Prospective Studies; D020545:Respiratory Mucosa; D014068:Tonsillectomy; D014867:Water
chemical_list: D014867:Water