Fornazieri Marco Aurélio, Miyazato Edson Satoshi, Yamamoto Henrique Massamiti, de Lima Navarro Paulo, de Rezende Pinna Fábio, Voegels Richard Louis
Pontifical Catholic University of Paraná, Londrina, PR, Brazil; Londrina State University, Department of Surgery, Londrina, PR, Brazil; University of São Paulo, São Paulo, São Paulo, Brazil.
Pontifical Catholic University of Paraná, Londrina, PR, Brazil.
Int J Pediatr Otorhinolaryngol. 2018 Aug;111:63-68. doi: 10.1016/j.ijporl.2018.05.029. Epub 2018 May 26.
It is not established whether reducing the exposure of the tonsillar fossa would be an effective strategy for postoperative pain relief among the pediatric population submitted to tonsillectomy. We assessed the impact of closing this region using absorbable sutures on pain, on the resumption of normal diet and on the healing process until seven days after surgery.
Randomized, double-blind, controlled trial comparing postoperative pain in 132 children between the ages of 5 and 12 years undergoing tonsillectomy having bilateral closure, unilateral closure or non-closure of the tonsillar fossa.
No differences in pain levels were reported both at discharge and on postoperative day 7. The day of resumption of normal diet was similar in all patients. Less granuloma and edema of the uvula were noted in patients with non-closure of the tonsillar fossa.
These results showed that reducing the exposure of the tonsillar fossa after the removal of the palatine tonsils was not an effective method for postoperative pain relief in children. Moreover, its closure was associated with slower healing.
对于接受扁桃体切除术的儿童群体，减少扁桃体窝暴露是否是缓解术后疼痛的有效策略尚未确定。我们评估了使用可吸收缝线封闭该区域对疼痛、正常饮食恢复以及术后七天内愈合过程的影响。
随机、双盲、对照试验，比较132名5至12岁接受扁桃体切除术的儿童，其扁桃体窝分别进行双侧封闭、单侧封闭或不封闭时的术后疼痛情况。
出院时和术后第7天，疼痛水平均无差异。所有患者恢复正常饮食的时间相似。扁桃体窝未封闭的患者中，悬雍垂的肉芽肿和水肿较少。
这些结果表明，腭扁桃体切除后减少扁桃体窝暴露并非缓解儿童术后疼痛的有效方法。此外，封闭扁桃体窝会导致愈合较慢。
