Protocol for post-tonsillectomy pain control in outpatient adults

Abstract

Introduction: Even though notable advances in anaesthetic and surgical techniques have appeared in recent years, morbidity, and especially pain, associated with tonsillectomy is still an important clinical problem.

Objectives: Assess the influence of a specific protocol for the control of postoperative pain and compare the frequency of complications in patients with and without it.

Methods: This was a descriptive, observational and prospective study on adult tonsillectomy patients in outpatient surgery. There were 2 groups: group 1, with 65 patients to whom a variable analgesic treatment was given; and group 2, with 50 patients with analgesic protocol and preoperative nursing interview. For the evaluation of pain, a numerical scale from 0 to 10 was used. The surgical techniques used were cold dissection or electric dissection.

Results: On the 4(th) day, group 1 (without protocol) presented a mean pain of 4.8 points on a numerical scale from 0 to 10, while group 2 (with protocol) presented mean of 3 (P=.0002). From group 1, 22 patients (36%) had to go to the emergency service, while 8 (16%) in group 2 did so (P=.019). On the 4(th) day, patients operated with cold dissection presented 3.7 points, as opposed to those operated with electric dissection, who presented 4.4 points.

Conclusions: A specific protocol applied to adult tonsillectomy patients in outpatient surgery is useful to obtain less pain and fewer complications.