Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada.
Laryngoscope. 2013 Feb;123(2):533-6. doi: 10.1002/lary.23627. Epub 2012 Aug 20.
OBJECTIVES/HYPOTHESIS: Pain after uvulopalatoplasty continues to cause patients significant morbidity, especially from the tonsillectomy portion. The literature describes multiple techniques to reduce post-tonsillectomy pain, none being definitive. The purpose of this study was to evaluate the effect of intraoperative ice pack application on post-uvulopalatoplasty pain.
Single-blinded, randomized controlled trial.
After inclusion and exclusion criteria were met, patients were enrolled and randomized, and subsequently underwent standard electrocautery uvulopalatoplasty. Packs were placed into the tonsillar fossae immediately following tonsil removal and into the palate after the palatoplasty. Patients then completed a questionnaire that evaluated their experience for 10 days following surgery. The primary outcome was pain rated on a visual analog scale. Return to work and return to normal diet were also assessed. T test and Mann-Whitney statistical analyses, as well as routine descriptive statistics, were conducted.
Eighteen subjects were recruited. Patients that received intraoperative cold packs experienced a statistically significant change in VAS average pain [3.4 ± 1.1 cm (p = 0.00001)] when compared with patients receiving room temperature packs. No difference in return to work (p = 0.16) and return to normal diet (p = 0.12) was identified.
Intraoperative ice pack administration results in significantly reduced pain following electrocautery uvulopalatoplasty.
目的/假设：悬雍垂腭咽成形术后的疼痛仍然会给患者带来很大的痛苦，尤其是来自扁桃体切除的部分。文献描述了多种减少扁桃体切除术后疼痛的技术，但没有一种是明确的。本研究的目的是评估术中冰袋应用对悬雍垂腭咽成形术后疼痛的影响。
单盲、随机对照试验。
符合纳入和排除标准后，患者被纳入并随机分组，随后接受标准电灼悬雍垂腭咽成形术。在扁桃体切除后立即将冰袋放入扁桃体窝，在腭成形术后将冰袋放入腭部。然后，患者完成了一份问卷，评估他们在手术后 10 天内的手术体验。主要结局是视觉模拟评分法（VAS）评估的疼痛。还评估了恢复工作和恢复正常饮食的情况。进行了 t 检验和曼-惠特尼统计分析，以及常规描述性统计。
共招募了 18 名受试者。与接受室温冰袋的患者相比，接受术中冷包的患者 VAS 平均疼痛明显改善[3.4±1.1cm(p=0.00001)]。在恢复工作（p=0.16）和恢复正常饮食（p=0.12）方面没有差异。
电灼悬雍垂腭咽成形术后术中冰袋的应用可显著减轻疼痛。
