title: Factors related to post-tonsillectomy pain in adults.
abstract: OBJECTIVE
  Assessment of factors related to pharyngeal anatomy and surgical technique as possible causes of post-tonsillectomy pain.
  
  
  METHODS
  This was a prospective observational study that included 42 patients undergoing tonsillectomy with cold and monopolar electric device dissection. We recorded duration of the entire operation, duration of electrocautery use, tonsil size and postoperative pain and discomfort assessed using a visual analogue scale (VS) and a 40-item questionnaire (QoR-40, Quality of Recovery), along with sequelae on returning to normal diet, weight loss and hospital stay. Correlations among quantitative variables were obtained by mean of lineal regression coefficients.
  
  
  RESULTS
  Duration of surgery was 22.66 ± 7.07 minutes, removing tonsils with a volume of 6046.07 ± 3866.20 mm(3) and an electrocautery use time of 66.14 ± 37.77 seconds, applying 1984.24 ± 1133.32 joules per patient. The most frequently observed Mallampati classification and tonsil size scores were stages II and III. The VS score increased and QoR-40 decreased at 24 hours and 7 days, but differences were statistically non-significant. Joule amount used for electrocautery was the parameter that correlated the best with discomfort status as measured via assessment scores, analgesic and corticosteroid requirements, weight loss and hospital stay. Pain was higher in subjects submitted to peritonsillar surgical aggression.
  
  
  CONCLUSIONS
  Improved use of electrodissection techniques, limiting and focusing the application of its energy, and preservation of peritonsillar mucosa are factors that may lower post-tonsillectomy pain levels.
authors.affiliation: Servicio de ORL, Departamento de Cirugía, Hospital Clínico Universitario, Universidad Literaria, Valencia, España. Electronic address: jgarciacall@hotmail.com.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: García Callejo
authors.affiliation: Servicio de ORL, Departamento de Cirugía, Hospital Clínico Universitario, Universidad Literaria, Valencia, España.
authors.forename: Inés
authors.initials: I
authors.lastname: Rincón Piedrahita
authors.affiliation: Servicio de ORL, Hospital General de Requena, Valencia, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Monzó Gandía
authors.affiliation: Servicio de ORL, Departamento de Cirugía, Hospital Clínico Universitario, Universidad Literaria, Valencia, España.
authors.forename: Oscar
authors.initials: O
authors.lastname: Sánchez Valenzuela
authors.affiliation: Servicio de ORL, Departamento de Cirugía, Hospital Clínico Universitario, Universidad Literaria, Valencia, España.
authors.forename: M Paz
authors.initials: MP
authors.lastname: Martínez Beneyto
authors.affiliation: Servicio de ORL, Departamento de Cirugía, Hospital Clínico Universitario, Universidad Literaria, Valencia, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Marzo Sanz
mesh_terms: D000328:Adult; D004564:Electrocoagulation / Q000009:adverse effects; D006801:Humans; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D014066:Palatine Tonsil; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects
keywords: Amigdalectomía; Dolor postoperatorio; Electrodisección; Electrodissection; Postoperative pain; Tonsillectomy