Nikanne Elina, Virtaniemi Jukka, Aho M, Kokki Hannu
Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland.
Otolaryngol Head Neck Surg. 2003 Nov;129(5):577-81. doi: 10.1016/S0194-59980301579-1.
In our previous study, we reported that both uvulopalatopharyngoplasty (UPPP) and tonsillectomy are associated with unacceptable intense pain during the first 24 hours after surgery. To investigate the pain progression at home, we followed the same 53 patients for 14 days after surgery. Twenty-two patients underwent tonsillectomy and 31 patients underwent UPPP.
A prospective, longitudinal, parallel-group study was conducted.
Beginning on the first postoperative day, the patients were allowed to use 50 mg ketoprofen capsules at a dosage of 5 mg/kg/24 hr. The patients evaluated their own pain four times a day for the first 5 days. Two weeks after the surgery during a follow-up visit patients reported the present pain; and a total consumption of analgesics, and all adverse events for 14 days.
Patients in both study groups had significant pain, especially in the morning, for the first week after surgery. In half of the patients, severe pain interfered with eating and sleeping, and in one third of the patients, the pain lasted 2 weeks or longer. The need for ketoprofen was significantly higher after UPPP than that after tonsillectomy (P = 0.001). One patient after tonsillectomy and 3 patients after UPPP needed electrocautery to stop secondary bleeding.
Both UPPP and tonsillectomy are associated with intense postoperative pain. Standard ketoprofen capsules are too short-acting to ensure undisturbed sleep.
在我们之前的研究中,我们报告了悬雍垂腭咽成形术(UPPP)和扁桃体切除术在术后24小时内均伴有难以忍受的剧痛。为了研究在家中的疼痛进展情况,我们对53例患者术后进行了14天的随访。22例患者接受了扁桃体切除术,31例患者接受了UPPP。
进行了一项前瞻性、纵向、平行组研究。
从术后第一天开始,允许患者以5mg/kg/24小时的剂量使用50mg酮洛芬胶囊。患者在术后前5天每天评估4次自身疼痛情况。术后两周随访时,患者报告当前疼痛情况、镇痛药的总消耗量以及14天内的所有不良事件。
两个研究组的患者在术后第一周均有明显疼痛,尤其是在早晨。一半的患者中,剧痛影响了进食和睡眠,三分之一的患者疼痛持续了2周或更长时间。UPPP术后对酮洛芬的需求显著高于扁桃体切除术后(P = 0.001)。1例扁桃体切除术后患者和3例UPPP术后患者需要电灼止血。
UPPP和扁桃体切除术均伴有强烈的术后疼痛。标准的酮洛芬胶囊作用时间过短,无法确保睡眠不受干扰。