gms | German Medical Science

81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

12.05. - 16.05.2010, Wiesbaden

Post-tonsillectomy pain-types and associated risk of haemorrhage

Meeting Abstract

  • corresponding author presenting/speaker Stephanie Sarny - Department of General Otorhinolaryngology, Head- and Neck Surgery, Medical University Graz, Austria
  • author Walter Habermann - Department of General Otorhinolaryngology, Head- and Neck Surgery, Medical University Graz, Austria
  • author Christoph Schmid - Department of General Otorhinolaryngology, Head- and Neck Surgery, Medical University Graz, Austria
  • author Guenther Ossimitz - Department of MAthematics, University Klagenfurt, Austria
  • author Heinz Stammberger - Department of General Otorhinolaryngology, Head- and Neck Surgery, Medical University Graz, Austria

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hno015

doi: 10.3205/10hno015, urn:nbn:de:0183-10hno0156

Veröffentlicht: 6. Juli 2010

© 2010 Sarny et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Tonsillectomy is one of the most frequently performed surgical procedures in the field of otorhinolaryngology. The main purpose of our study was the evaluation of post-tonsillectomy pain-types and their associated risk of haemorrhage.

Methods: Questionnaires were sent to 615 patients undergoing tonsillectomy with or without adenotomy between January 2007 and June 2008 at the Department of ORL, H&NS, MU of Graz, Austria. For each patient the postoperative treatment, haemorrhage risk and pain were recorded. Postoperative pain was measured on a visual analogue scale, with 0 representing “no pain” and 10 indicating “worst pain”, for 5 time periods (1st day, 2nd–3rd day, 4th–7th day, 7th–14th day and after 14th day).

Results: Five typical pain types were found on account of cluster analysis. Pain type I (24.8%) shows constant low pain. Pain type II (50.75%) displays significant pain until the 3rd postoperative day and then declines. Pain type III (10.75%) means low pain at the beginning which increases after the 4th day until it becomes significant pain and decreases again after 14 days. The rare pain type IV (1.2%) is similar to pain type III but with significant pain lasting until 14 days postoperatively. Pain type V (12.5%) shows constant significant pain then declining slowly. The haemorrhage rate of pain type I is low but of pain type V extremely high.

Summary: The intensity of pain correlates significantly (p<0.01) with haemorrhage rates. Patients suffering from significant pain more than two weeks postoperatively are on risk of haemorrhage.


References

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Hasan, H., et al. Randomized study comparing postoperative pain between coblation and bipolar scissor tonsillectomy. Eur Arch Otorhinolaryngol. 2008; 265:817-20.
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Rosbe, K. W., et al. Efficacy of postoperative follow-up telephone calls for patients who underwent adenotonsillectomy. Arch Otolaryngol Head Neck Surg. 2000; 126: 718-21
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Schmidt, R., et al. Complications of tonsillectomy: a comparison of techniques. Arch Otolaryngol Head Neck Surg. 2007; 133: 925-8.
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Lowe, D., et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope. 2007; 117: 717-24.