Hatami Maryam, Mirjalili Mahdieh, Ayatollahi Vida, Vaziribozorg Sedighe, Zand Vahid
Department of Anesthesiology, Pain Research Center, Shahid Sadoughi University of Medical Sciences.
Department of Otolaryngology, Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
J Craniofac Surg. 2018 Jun;29(4):e384-e387. doi: 10.1097/SCS.0000000000004393.
The authors investigated the effect of honey on post-tonsillectomy pain and compare its efficacy with tramadol.
This clinical trial was performed on 60 patients with American Society of Anesthesia I and II aged between 18 and 55 years and underwent tonsillectomy. Induction of anesthesia was carried out using 2 mg/kg propofol and 0.5 atracurium following 1.5 μg/kg fentanyl administration. Group B was given tramadol at dose of 2 mg/kg and with volume of 4 mL and Group A was given normal saline with the same volume 2 mL of medications were injected using needle (25) into tonsil bed and anterior old of each tonsil by an anesthesiologist. Three minutes after injection, the surgery was performed by the same ENT residents for all patients. In the recovery room Group B received antibiotics and oral acetaminophen. Group A was given antibiotics, oral acetaminophen, and honey dissolved in 40 mL warm water every 6 hours from when the patient was fully awake. Patients in Group A were told to eat honey 3 times a day 7 days postoperatively. Pain was scored using Numeric Rating Scale at the time points of 2, 6, 12, and 24 hours as well as 3 and 7 days postoperatively. Moreover, the healing status and epithelialization degree of tonsillar bed were considered on 1 and 7 days after the surgery by ENT specialist.
The mean of pain score was significantly higher in Group A within 24 hours postoperatively as compared with Group B (P < 0.01). The mean of pain score was lower in Group B after 3 and 7 days but this difference was not statistically significant (P > 0.05). Considering restoration status and epithelialization degree of tonsillar bed on the 1st and 7th days, there was no statistically significant difference between 2 groups; however, tonsillar bed healing process was better in Group B on the 7th day.
The current investigation confirmed the positive impact of tramadol on post-tonsillectomy pain relief in adults. The authors also found that honey can be used as a complementary treatment along with acetaminophen and other analgesics for reducing post-tonsillectomy pain. Considering honey impact on wound healing and its anti-inflammatory effect, it is suggested for relieving complications after surgery.
作者研究了蜂蜜对扁桃体切除术后疼痛的影响，并将其疗效与曲马多进行比较。
本临床试验对60例年龄在18至55岁之间、美国麻醉医师协会分级为I级和II级且接受扁桃体切除术的患者进行。麻醉诱导采用2mg/kg丙泊酚和0.5mg阿曲库铵，给药前先给予1.5μg/kg芬太尼。B组给予2mg/kg剂量、4mL体积的曲马多，A组给予相同体积的生理盐水。由麻醉医生用25号针头将2mL药物注入每个扁桃体的扁桃体床和前柱。注射三分钟后，由同一名耳鼻喉科住院医生为所有患者进行手术。在恢复室，B组接受抗生素和口服对乙酰氨基酚。A组从患者完全清醒时起每6小时给予抗生素、口服对乙酰氨基酚以及溶解在40mL温水中的蜂蜜。A组患者被告知术后7天每天食用蜂蜜3次。在术后2、6、12和24小时以及术后3天和7天的时间点使用数字评分量表对疼痛进行评分。此外，耳鼻喉科专家在术后1天和7天评估扁桃体床的愈合状况和上皮化程度。
术后24小时内，A组的平均疼痛评分显著高于B组（P < 0.01）。术后3天和7天，B组的平均疼痛评分较低，但差异无统计学意义（P > 0.05）。考虑到术后第1天和第7天扁桃体床的恢复状况和上皮化程度，两组之间无统计学显著差异；然而，在第7天，B组的扁桃体床愈合过程更好。
当前研究证实了曲马多对成人扁桃体切除术后疼痛缓解有积极影响。作者还发现，蜂蜜可与对乙酰氨基酚和其他镇痛药一起用作辅助治疗，以减轻扁桃体切除术后疼痛。考虑到蜂蜜对伤口愈合的影响及其抗炎作用，建议用于缓解术后并发症。
