Article
Pain medication after tonsillectomy – is there a sense in using a visual analogue pain scale?
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Authors
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Jochen Karcher
- Caritasklinik St. Theresia - HNO-Klinik, Saarbrücken
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Ludwig Distler
- Caritasklinik St. Theresia - HNO-Klinik, Saarbrücken
| Published: | September 22, 2005 |
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Outline
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Introduction: Due to the postoperative pain, the tonsillectomy is known to be one of the most unpleasant operations in the field of ENT.
Pain being a completely subjective feeling, we wanted to analyze the postoperative pain levels using an analogue pain scale and how it influences pain medication.
Methods: 95 patients following a tonsillectomy were asked on postoperative days 1 – 5 to mention their pain level continuously using an analogue pain scale. The pain scale reached from 0 (no pain) to 10 (maximum unbearable pain). The pain medication and the subjective pain level were documented on 8 times a day for 5 days following surgery.
As pain medication, diclofenac (Voltaren®) 50 mg suppository or Voltaren Dispers® (75 mg diclofenac, retarded dose) was used 3 to 4 times a day on a regular basis. Spoken and written pain statements were written down.
Results: The average pain level on postoperative day 1 to 5 reached from 3 to 6. The pain levels during the night were in average higher than during the day. The highest pain level was seen on days 1 and 4 following surgery. The personal pain threshold and dosage of the needed pain medication differed a lot.
In patients with a higher pain threshold, no stronger pain medication was needed in 10% of all registered events. In 6% of the patients stronger pain made a stronger pain medication necessary and the given pain score rose up to levels over 6.5. With the given pain medication a sufficient pain therapy was feasible in 84% of the patients.
Conclusion: The visual analogue pain scale is very useful for the documentation of pain and its course, when used regularly. Patients with pain levels over 6.5 may need a stronger pain medication. Before changing the medication the actual complaint should be discussed with the patient to make sure, a higher dose of medication is needed.
The pain scale gives the patient another possibility to communicate with his medical staff and should, when often used, lead to a faster improvement of the postoperative pain situation.
