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Post-tonsillectomy pain: Different modes of pain relief

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Abstract

Sixty patients aged 15 to 40 years of either sex, American Society of Anaesthesiologists (ASA) grade I and II, undergoing tonsillectomy, were randomly allocated to receive either preroperative intramuscular diclofenac sodium(group A) or pre- incisional bilateral infiltration of bupivacaine in the peritonsillar fossa (group B) or post operative Trunscutaneous Electric Nerve Stimulation - TENS (group C) at fixed time intervals. Pain scores (Visual analogue scale VAS, 0- 100 mm) were assessed at rest and on deglutition at 1,3,6,9,12 and 24 hours after surgery. Pentazocine 1actale 15 mg IV was given as rescue analgesic whenever VAS estimation was more than 30 mm at rest (not deglutition). Constant incisional pain was significantly less ( p < 0.01 ANOVA) in group C after 3 hours of surgery as compared to group A and B. Similarly pain on deglutition was significantly less (p <0.01, ANOVA) in group C during the entire study period as compared to Group A and B. There was significant reduction of VAS (p< 0.01) immediately after TENS therapy at 0, 4 and 8 hours. Rescue analgesic consumption was significantly lower in TENS group. Thus, TENS seems to be an effective therapeutic modality for post tonsillectomy pain relief as compared to the other two methods.

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References

  1. Jebeles JA, Reilly JS, Gutierrez IF, Bradley Jr EL, Kissin I: The effect of preincisional infiltration of tonsils with bupivacaine on the pain following tonsillectomy under general anaesthesia. Pain 1991; 47: 305–8.

    Article  PubMed  CAS  Google Scholar 

  2. Stuart JC, MacGregor FB, Cairns CS, Chandrachud HR: Peritonsillar infiltration with bupivacaine for paediatric tonsillectomy. Anaes and Intensive care 1994; 22 : 679–82.

    CAS  Google Scholar 

  3. Raj TB, Wickham MH: The effect of benzydamine hydrochloride (difflam) spray on post-tonsillectomy symptoms : A double blind study. The J of Laryngol Otol1986; 100 : 303–6.

    CAS  Google Scholar 

  4. Watters CH, Patterson CC, Mathews HML, Campbell W: Diclofenac sodium for post-tonsillectomy pain in children. Anaesthesia 1988; 43:641–3.

    Article  PubMed  CAS  Google Scholar 

  5. Freeman SB and Markwell JK: Sucralfate in alleviating post- tonsillectomy pain. Laryngoscope 1992; 102 : 1242–6.

    Article  PubMed  CAS  Google Scholar 

  6. Lombard B, Tomasi M, Charpentier, P, Drouet Y, Saigas P: Evaluation of transcutaneous electrostimulation in the management of post-tonsillectomy pain in adults.RevLaryngol- Otal-Rhinol-Bord 1996; 117: 89–92.

    CAS  Google Scholar 

  7. Hannington - Kiff JG: The need for analgesic cover after ENT surgery — comparison of nefopam and papaveretum.Anaesthesia 1985; 40 : 76–8.

    Article  Google Scholar 

  8. Jakobsson J, Rane K, Davidson S: Intramuscular NSAIDS reduce post-operative pain after minor out patient anaesthesia.Eur J Anaesthesiol 1996; 13: 67–71.

    Article  PubMed  CAS  Google Scholar 

  9. Bloedel J and McCreery D: Organization of peripheral and central pain pathways,SurgNeurol 1975; 4: 65–81.

    CAS  Google Scholar 

  10. Soric R and Devlin M: Transcutaneous electrical nerve stimulation. Practical aspects and applications.Postgrad Med, 1985; 78: 101–6.

    PubMed  CAS  Google Scholar 

  11. Rao VR, Wolf SL, Gerah MR: Examination of electrode placements and stimulating parameters in treating chronic pain with conventional transcutaneous electrical nerve stimulation (TENS).Pain 1981; 11: 37–47.

    Article  PubMed  CAS  Google Scholar 

  12. Seymour RA: The use of pain scales in assessing the efficacy of analgesics in postoperative dental pain.Eur J Clin Pharmacol 1982; 23: 441–4.

    Article  PubMed  CAS  Google Scholar 

  13. Stage J, Jensen JH, Bonding P: Post-tonsillectomy haemorrhage and analgesics. A comparative study of acetyl salicylic acid and paracetamol. Clin Otololaryngol 1988; 13:201–4.

    Article  CAS  Google Scholar 

  14. Dooley DM, and Kasprak M: Modification of the blood flow to the extremities by electrical stimulation of nervous system. South Med J 1976; 69: 1309.

    PubMed  CAS  Google Scholar 

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Gupta, A.K., Gupta, S., Meena, D.S. et al. Post-tonsillectomy pain: Different modes of pain relief. Indian J Otolaryngol Head Neck Surg 54, 136–139 (2002). https://doi.org/10.1007/BF02968733

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