Keywords
analgesia patient-controlled
tonsillectomy
postoperative pain.
Abstract
Introduction: Tonsillectomy is surgical procedure which is being every time more often in adult patients. Postoperative pain may be very intense, and it has a very important mark in the quality of life of our patients. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) may not be enough for pain management during the first 48 hours post-surgery. Morphine patient-controlled analgesia (PCA) is an effective and safe alternative for postoperative acute pain management. Material and methods: Our main goal was to compare the quality of analgesia between morphine PCA and acetaminophen and NSAIDs use for acute pain control in adult patients who had tonsillectomy surgery. Our secondary goal was to study the frequency of side effects and the satisfaction level on each group. A retrospective cohort study was performed with those adult patients who underwent tonsillectomy during the year 2017. Pain was evaluated during the first 24 and 48 hours post-surgery with the numerical rating scale (NRS). Secondary side effects were reported. The statistical study was performed with SPSS® programme. Results: a total of 46 patients were evaluated, 20 patients belonged to the group for conventional analgesia and 26 belonged to the group of morphine PCA. We did not find significative differences in the demographic characteristics in both groups. PCA group had a smaller NRS compared to the other conventional analgesia group during the first 24 and the 48 hours. The difference was statistically significant for pain control during activity and resting. The incidence of secondary effects was greater for the PCA group (46,15 %) than for the acetaminophen and NSAIDs group (15 %). Discussion: Analgesia with morphine PCA is more effective than the administration of acetaminophen and NSAIDs for postoperative pain control in tonsillectomy procedure in the adult patient. The adverse effects are more frequent with morphine PCA.References
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