Article
Post-tonsillectomy pain-types and associated risk of haemorrhage
Search Medline for
Authors
Published: | July 6, 2010 |
---|
Outline
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
- 1.
- Hasan, H., et al. Randomized study comparing postoperative pain between coblation and bipolar scissor tonsillectomy. Eur Arch Otorhinolaryngol. 2008; 265:817-20.
- 2.
- 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
- 3.
- Schmidt, R., et al. Complications of tonsillectomy: a comparison of techniques. Arch Otolaryngol Head Neck Surg. 2007; 133: 925-8.
- 4.
- Lowe, D., et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope. 2007; 117: 717-24.