Comparison of three different analgetic therapy concepts following tonsillectomy

A sufficient analgetic therapy after tonsillectomy is despite many studies still an all-day challenge in clinical life. So 340 patients following tonsillectomy at the Clinic for ENT Surgery at AMEOS Halberstadt could be compared in a retrospective study between 1st January 2012 and 31st December 2015. Primary subject was the possible advantage of an pre-emptive analgesia and the use of opioids. Three therapy groups could be defined: 1. Diclofenac dispers plus Metamizol, 2. Diclofenac retard plus Metamizol and 3. Diclofenac retard plus Oxycodon retard. The retarded medication had been given together with pre-operative medication. Tonsillectomy had been performed in cold technique (scissors and raspatorium).

A comparison of NRS values between the three therapy groups showed no significant difference but a slight advantage could be shown for group 3. The therapy groups showed different profiles of postoperative bleeding without direct evidence of higher primary or secondary bleeding rates in a defined group. A statistic significant higher rate of obstipation could be shown for the opioid group. An analysis of gender and age showed a significant higher rate of postoperative bleeding in men as well as higher data in NRS (numeric rating scale) in female patients.

All together no clear recommendation could be given for the use of pre-emptive analgesia as well as for the use of opioids in treatment of postoperative pain following tonsillectomy in adults. In future we should support further research for the development of new therapy concepts and educate patients and medical stuff in possibilities and character of modern analgetic treatment.

Publication History

Publication Date:
23 April 2019 (online)