Santosh U P, Chadha Baneet, Jemima Parveen H
Department of Otorhinolarngology, J J M Medical College, Davangere, Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4322-4326. doi: 10.1007/s12070-024-04845-y. Epub 2024 Jun 29.
Tonsillectomy till date continues to be the most frequently performed surgery by ENT surgeons, and with that comes the most challenging complication of post-tonsillectomy pain and its management that affects the patient morbidity and alters the hospital course. Various methods and techniques have been implicated in the post-operative pain management in patients undergoing tonsillectomy. To compare the post operative pain following local infiltration of Dexamethasone and Triamcinolone in patients undergoing Tonsillectomy. Total of 50 patients were selected and randomized into two groups- Group 1 and Group 2, who underwent local infiltration of Dexamethasone and Triamcinolone respectively to maintain uniformity. Baseline scoring (0 h post operatively) and follow up scoring after 6 h and 24 h was done using the Visual Analogue Scale and were evaluated and documented as per their response to treatment. A significant reduction was observed in the severity of pain in both groups with an average reduction of mean score from 9.50 to 5.92 in Group 1 and from 9.04 to 3.90 in Group 2 at the end of 24 h post-operatively. The mean score of Group 2 was greater and showed better improvements in VAS pain score and was statistically significant ( < 0.001). Usage of steroidal preparations locally during tonsillectomy helps combat the post-operative pain. Usage of Triamcinolone locally has proved beneficial in reducing the post-operative tonsillectomy pain.
迄今为止，扁桃体切除术仍然是耳鼻喉科医生最常进行的手术，随之而来的是扁桃体切除术后疼痛这一最具挑战性的并发症及其管理问题，它会影响患者的发病率并改变住院进程。多种方法和技术都被应用于扁桃体切除术后患者的疼痛管理。比较地塞米松和曲安奈德局部浸润对扁桃体切除术后患者疼痛的影响。共选取50例患者并随机分为两组，即第1组和第2组，分别接受地塞米松和曲安奈德的局部浸润，以保持一致性。术后0小时进行基线评分，术后6小时和24小时使用视觉模拟量表进行随访评分，并根据患者对治疗的反应进行评估和记录。术后24小时时，两组疼痛严重程度均显著降低，第1组平均评分从9.50降至5.92，第2组从9.04降至3.90。第2组的平均评分更高，视觉模拟量表疼痛评分改善更明显，且具有统计学意义（<0.001）。扁桃体切除术中局部使用甾体类制剂有助于对抗术后疼痛。局部使用曲安奈德已被证明有助于减轻扁桃体切除术后的疼痛。
