gms | German Medical Science

82. 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.

01.06. - 05.06.2011, Freiburg

Bleeding after tonsillectomy – a retrospective analysis considering postoperative analgesia

Meeting Abstract

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German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Freiburg, 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hno04

doi: 10.3205/11hno04, urn:nbn:de:0183-11hno046

Veröffentlicht: 3. August 2011

© 2011 Kohl et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



The tonsillectomy is still one of the most performed operations in ENT surgery. However bleeding after the procedure may become a severe problem which needs professional handling. Postoperative analgesia especially with NSAID (non-steroidal anti inflammatory drugs) like Voltaren disp.® plays an important roll in clinical practice and is an often discussed topic.

Preparing for a prospective study we analysed 776 patients undergoing a tonsillectomy from 01/09 till 06/11 in our clinic. As excluding factors we defined the advanced tumor tonsillectomy, the tonsillotomy and a quitting of further clinical treatment before the 6th postoperative day (n=43). Personal data (age, gender), the moment of bleeding, the need of surgical intervention as well as the prescribed analgesia were compared in a table.

In 733 patients we found 64 bleedings from which 50% required surgical intervention (4.42%). A higher rate of postoperative bleeding could be seen at the age group from 21 to 30 years without any gender-related accumulation.

For analgesia after the procedure we used NSAID in a determinded scheme (mostly Voltaren disp.® (Diclofenac) 3x1 tablet) as well as other pain killers on demand. An increased need of pain releasing drugs showed on the 2nd and 4th postoperative day. Specially concerning Voltaren disp.® we found a higher rate of primary bleeding (first 24 hours after the procedure) as well as a decreased rate of bleeding complications from the 2nd till 6th postoperative day.

More bleeding complications in patients aged 21 to 30 could be found in other studies as well incriminating a higher rate of incompliance in this age group. An increased demand of pain killers on the 2nd and 4th postoperative day requires a modulation of analgesic scheme. A stringent rate of primary bleeding is to be discussed as reasons for bleeding in the first 24 hours after the procedure can usually be found in operation techniques.