Ince Ilker, Yoruk Ozgur, Ahiskalioglu Ali, Aksoy Mehmet, Dostbil Aysenur, Celik Mine
Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey
Department of Otorhinolaryngology, Ataturk University School of Medicine, Erzurum, Turkey.
Otolaryngol Head Neck Surg. 2015 Aug;153(2):269-74. doi: 10.1177/0194599815580976. Epub 2015 Apr 16.
Tonsillectomy surgery is associated with severe postoperative pain that usually requires analgesics including opioids. Pain control is still a big problem after tonsillectomy surgery. We aimed to evaluate the efficacy of preemptive analgesia using montelukast for pediatric post-tonsillectomy pain management. This is the first-time use of montelukast in post-tonsillectomy pain.
Double-blind, controlled-randomized study.
University teaching and research hospital.
A total of 60 children, aged 5 to 15 years, American Society of Anesthesiologist class I-II, scheduled for elective tonsillectomy were enrolled in this clinical trial study. The patients were randomized into 2 groups: the montelukast group (group M, n = 30) and control group (group C, n = 30). Group M recieved an oral montelukast tablet and group C recieved placebo at 2400pm on the morning before surgery. Post-tonsillectomy pain was evaluated with the Wong-Baker FACES Scale during the 24 hours after surgery. Patients' intraoperative hemodynamic parameters and intraoperative and postoperative complications were recorded.
There were statistically significant differences between group C and group M for Wong-Baker FACES pain rating scale scores (P < .05). In the 24 hours after surgery, the total number of patients using rescue analgesics was higher in group C than in group M, and the difference was statistically significant (P < .001). There was no significant difference in demographic parameters (P > .05). There were no significant differences in postoperative nausea and vomiting, otalgia, trismus, fever, or halitosis between the groups (P > .05).
Preemptive montelukast can be used safely to reduce the serious pain caused by tonsillectomy in children.
扁桃体切除术与严重的术后疼痛相关，通常需要使用包括阿片类药物在内的镇痛药。扁桃体切除术后的疼痛控制仍然是一个大问题。我们旨在评估孟鲁司特用于小儿扁桃体切除术后疼痛管理的超前镇痛效果。这是孟鲁司特首次用于扁桃体切除术后疼痛。
双盲、对照随机研究。
大学教学和研究医院。
本临床试验共纳入60例年龄在5至15岁、美国麻醉医师协会分级为I-II级、计划行择期扁桃体切除术的儿童。患者被随机分为两组：孟鲁司特组（M组，n = 30）和对照组（C组，n = 30）。M组在手术前一天晚上24:00口服孟鲁司特片，C组服用安慰剂。术后24小时内采用面部表情疼痛评分量表评估扁桃体切除术后疼痛。记录患者术中血流动力学参数以及术中和术后并发症。
C组和M组在面部表情疼痛评分量表得分上存在统计学显著差异（P < .05）。术后24小时内，C组使用补救镇痛药的患者总数高于M组，差异具有统计学意义（P < .001）。人口统计学参数无显著差异（P > .05）。两组术后恶心呕吐、耳痛、牙关紧闭、发热或口臭方面无显著差异（P > .05）。
超前使用孟鲁司特可安全用于减轻儿童扁桃体切除术后的严重疼痛。
