Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.
PLoS One. 2020 Feb 10;15(2):e0228481. doi: 10.1371/journal.pone.0228481. eCollection 2020.
To analyze the effect of adjuvant oral application of honey for treating postoperative pain after tonsillectomy.
Single centre prospective cohort study.
Two cohorts of patients after tonsillectomy.
56 patients treated with honey 8 times per day (honey group), 18 patients treated without honey (control group); baseline analgesia were non-steroidal anti-inflammatory drugs (NSAID) or coxibs; opioids were used as pro re nata (PRN) medication; mean age 34.4 ± 13.4 years; 36% women.
On first to fifth postoperative day, patients rated their pain using the validated questionnaire of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale (NRS, 0-10) for determination of patient's pain. QUIPS allows standardized assessment of patients' characteristics andpain-associated patient-reported outcomes (PROs). The influence of preoperative and postoperative parameters on patients' postoperative pain were estimated by univariate and multivariate statistical analysis.
Average pain in activity in the control group was greater than 4 (NRS 4.4 ± 2.4) during the first five postoperative days, with a renewed increase in pain intensity on the fifth day (4.3 ± 2.5). In the honey group, the pain in activity decreased without any further pain increase and was only higher than 4 on the first three postoperative days (4.3 ± 2.1, all p>0.05). However; neither minimal nor maximal pain were significantly different between both groups on the first postoperative day (p = 0.217, p = 0.980). Over the five postoperative days, the minimal and maximal pain in the honey group decreased continuously and faster than in the control group. With regard to pain-related impairments on the first day, the honey group reported less pain-related sleep disturbance (p = 0.026), as well as significantly fewer episodes of postoperative oral bleeding (p = 0.028) than the control group. Patients without honey consumption had on the first and fifth postoperative day a higher risk of increased minimal pain (OR = -2.424, CI = -4.075 --0.385). Gender was an independent factor for compliance of honey consumption on the second postoperative day (p = 0.037). Men had a lower probability for compliance of honey consumption (OR = -0.288, CI = -2.863 --0.090).
There was a trend of reduced postoperative pain after oral honey application. Honey also seems to reduce pain-related impairments. The need for additional opioids on the first day could be reduced. A larger controlled trial is now needed to varify the effect of honey on pain after tonsillectomy.
German Clinical Trials Register DRKS00006153. The authors confirm that all ongoing and related trials for this drug/intervention are registered.
分析扁桃体切除术后辅助口服蜂蜜治疗术后疼痛的效果。
单中心前瞻性队列研究。
接受扁桃体切除术的两组患者。
56 例每天 8 次接受蜂蜜治疗的患者（蜂蜜组），18 例未接受蜂蜜治疗的患者（对照组）；基线镇痛为非甾体抗炎药（NSAID）或 COX-2 抑制剂；阿片类药物为按需使用；平均年龄 34.4 ± 13.4 岁；36%为女性。
术后第 1 至 5 天，患者使用经过验证的德国术后疼痛治疗质量改进项目（QUIPS）问卷评估疼痛，包括用于确定患者疼痛的数字评分量表（NRS，0-10）。QUIPS 允许对患者特征和与疼痛相关的患者报告结果（PRO）进行标准化评估。通过单变量和多变量统计分析，评估术前和术后参数对患者术后疼痛的影响。
对照组在术后第 1 至 5 天的活动时平均疼痛评分大于 4（NRS 4.4 ± 2.4），第 5 天疼痛强度再次增加（4.3 ± 2.5）。在蜂蜜组中，活动时的疼痛减轻，没有进一步的疼痛增加，仅在前 3 天疼痛评分大于 4（4.3 ± 2.1，均 p>0.05）。然而，两组在术后第 1 天的最小和最大疼痛均无显著差异（p = 0.217，p = 0.980）。在术后 5 天内，蜂蜜组的最小和最大疼痛持续且较对照组更快地下降。关于第 1 天与疼痛相关的损伤，蜂蜜组报告的疼痛相关睡眠障碍（p = 0.026）以及术后口腔出血发作（p = 0.028）明显少于对照组。术后第 1 天和第 5 天未服用蜂蜜的患者发生最小疼痛增加的风险更高（OR = -2.424，CI = -4.075 --0.385）。性别是术后第 2 天蜂蜜摄入依从性的独立因素（p = 0.037）。男性服用蜂蜜的可能性较低（OR = -0.288，CI = -2.863 --0.090）。
口服蜂蜜后术后疼痛有减轻的趋势。蜂蜜似乎还可以减轻与疼痛相关的损伤。第 1 天需要额外的阿片类药物的可能性降低。现在需要更大规模的对照试验来验证蜂蜜对扁桃体切除术后疼痛的影响。
德国临床试验注册中心 DRKS00006153。作者确认该药物/干预措施的所有正在进行和相关试验均已注册。
