Idris Rahimah, Ramli Ramiza Ramza, Yaacob Wan NorSyafiqah W, Hassan Shahid
Department of Otorhinolaryngology, Head and Neck Surgery, Pantai Hospital Laguna Merbok, Bandar Laguna Merbok, Sungai Petani, Kedah, Malaysia.
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
Int Arch Otorhinolaryngol. 2024 Mar 19;28(3):e440-e450. doi: 10.1055/s-0043-1777295. eCollection 2024 Jul.
Tonsillectomy is one of the most common operations performed by otorhinolaryngology surgeons worldwide; however, the insufficient quality of the postoperative pain management and effective posttonsillectomy pain relief remain a clinical dilemma. To evaluate the efficacy of applying bismuth iodine paraffin paste (BIPP) to the dissected fossa as an adjuvant therapy for a better outcome in terms of posttonsillectomy pain management and due to its wound healing properties. The present is a prospective randomized control pilot study with 44 patients aged > 7 years who underwent tonsillectomy. The patients were divided into two groups: the control group and the group that had BIPP applied to the dissected tonsillar fossa. The visual analogue scale score and the post-onsillectomy percentage of tonsillar fossa epithelization were recorded and evaluated. Both subjectively and objectively, there a was statistically significant pain-relieving effect in the BIPP group within the first 5 postoperative days ( < 0.05). From postoperative day 3 onward, the dissected area of the tonsillar fossa healed significantly faster in the BIPP group compared with the control group, and it became stable on day 14. The topical application of BIPP showed a better pain-relieving effect, it was safe, and hastened wound healing after tonsillectomy.
扁桃体切除术是全球耳鼻喉科医生进行的最常见手术之一；然而，术后疼痛管理质量不足以及扁桃体切除术后有效的疼痛缓解仍然是一个临床难题。为了评估将铋碘石蜡糊剂（BIPP）应用于手术切除窝作为辅助治疗在扁桃体切除术后疼痛管理方面取得更好效果的疗效，以及因其具有促进伤口愈合的特性。本研究是一项前瞻性随机对照试验研究，纳入了44例年龄大于7岁且接受扁桃体切除术的患者。患者被分为两组：对照组和在手术切除的扁桃体窝应用BIPP的组。记录并评估视觉模拟量表评分以及扁桃体窝上皮化的扁桃体切除术后百分比。主观和客观上，BIPP组在术后第1个5天内均有统计学显著的止痛效果（P<0.05）。从术后第3天起，BIPP组扁桃体窝的手术切除区域愈合明显快于对照组，并在第14天趋于稳定。BIPP的局部应用显示出更好的止痛效果，安全且加速了扁桃体切除术后的伤口愈合。
