Unsal Ozlem, Akpinar Meltem, Bozkurt Gulpembe, Soytas Pinar, Ekici Merve, Turk Bilge, Coskun Berna Uslu
Department of Otorhinolaryngology Head and Neck Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey.
Department of Otorhinolaryngology Head and Neck Surgery, Acibadem University Atakoy Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):101-107. doi: 10.14744/SEMB.2020.75735. eCollection 2021.
Adenotonsillectomy is one of most common surgeries performed in childhood. Post-operative pain associated particularly with tonsillectomy is still a problem for many physicians. Despite advances in surgical techniques, analgesics, or anti-inflammatory drugs, no unique strategy for post-tonsillectomy pain management has been suggested. The aim of this study is to investigate the analgesic effect of steroid containing nasal spray applied to tonsillar region after tonsillectomy.
Eighty-two patients were assigned into two groups as study and control. In study group, nasal spray containing steroid was applied to each tonsillar region after surgery for 5 days. Post-operative pain of all patients was assessed using a visual analog scale and results were compared.
Pain decreased gradually over time in both the study and control groups. Although the pain scores from 4 h post-surgery to post-operative day 5 were not found to significantly decrease in children that used nasal spray containing steroid, these patients developed less pain on post-operative day 5,with statistical significance (p<0.05).
Post-tonsillectomy pain was reported to increase around post-operative day 5, which coincides with the time of intense wound inflammation. Therefore, significant pain reduction on post-operative day 5 observed in children that used nasal spray with steroid may have clinical importance for overcoming this problem.
腺样体扁桃体切除术是儿童期最常见的手术之一。术后疼痛，尤其是扁桃体切除术后的疼痛，对许多医生来说仍是一个问题。尽管手术技术、镇痛药或抗炎药有所进步，但尚未提出针对扁桃体切除术后疼痛管理的独特策略。本研究的目的是探讨扁桃体切除术后在扁桃体区域应用含类固醇鼻喷雾剂的镇痛效果。
82例患者被分为研究组和对照组。研究组在术后5天对每个扁桃体区域应用含类固醇的鼻喷雾剂。使用视觉模拟量表评估所有患者的术后疼痛情况并比较结果。
研究组和对照组的疼痛均随时间逐渐减轻。虽然在使用含类固醇鼻喷雾剂的儿童中，术后4小时至术后第5天的疼痛评分未发现明显降低，但这些患者在术后第5天疼痛减轻，具有统计学意义（p<0.05）。
据报道，扁桃体切除术后疼痛在术后第5天左右会加重，这与伤口强烈炎症的时间相吻合。因此，在使用含类固醇鼻喷雾剂的儿童中观察到术后第5天疼痛显著减轻，这对于克服这一问题可能具有临床重要性。
