Update review of pain control methods of tonsil surgery

Auris Nasus Larynx. 2020 Feb;47(1):42-47. doi: 10.1016/j.anl.2019.10.002. Epub 2019 Oct 28.

Abstract

Pain after tonsil surgery is troublesome because it causes discomfort. In addition, handling patients with postoperative pain is challenging to otolaryngologists. Many laboratory studies have assessed the use of analgesics and surgical techniques to discover methods for effective control of postoperative pain associated with tonsil surgery. In this review article, we summarize and provide a comprehensive overview of current methods for the control of pain after tonsil surgery based on findings of recent studies. Although powered intracapsular tonsillotomy is not popular yet, it seems to be an effective option among various surgical techniques. More discussion about powered intracapsular tonsillotomy should be done in the future. On the other hand, surgery with a harmonic scalpel, fibrin glue, or cryoanalgesia seems ineffective. When reviewing medical treatment methods, the use of nonsteroidal anti-inflammatory drugs, steroids, and/or gabapentin/pregabalin seems to be effective. However, the use of opioid (especially codeine) for children should be avoided because of possible respiratory insufficiency. Ketorolac is dangerous because of the risk of hemorrhage. We should continue to focus on the development of novel postoperative pain control techniques with no or low complications.

Keywords: Nonsteroidal ati-inflammatory drugs; Postoperative pain; Steroids; Tonsil surgery.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Analgesics / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Cryotherapy / methods
  • Electrocoagulation / methods
  • Gabapentin / therapeutic use
  • Humans
  • Hydrocodone / therapeutic use
  • Laser Therapy / methods
  • Pain, Postoperative / prevention & control*
  • Pain, Postoperative / therapy
  • Pregabalin / therapeutic use
  • Radiofrequency Ablation / methods
  • Tonsillectomy / methods*
  • Tramadol / therapeutic use
  • Ultrasonic Surgical Procedures / methods

Substances

  • Adrenal Cortex Hormones
  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Tramadol
  • Pregabalin
  • Gabapentin
  • Hydrocodone