• María Luz Magdalena, Luisa Caragol, Antonio Solé, and Juan Pablo Rodrigo.
• Unidad de Cirugía Mayor Ambulatoria, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España. Electronic address: luzcolloto@gmail.com.
• Acta Otorrinolaringol Esp. 2014 Mar 1;65(2):102-8.

Introduction And ObjectivesTonsillectomy causes a moderate to severe postoperative pain, and its treatment is an unsolved problem. The objective of this study was to compare the effectiveness of 2 analgesic protocols and their related complications.MethodsTwo groups of adult patients submitted to ambulatory tonsillectomy were studied. In group 1, 52 patients received a combination of tramadol and NSAIDs postoperatively; in group 2, 60 patients were treated with prednisone and NSAIDs. Two surgical techniques were used: cold dissection or dissection with electrocautery. Pain was recorded on days 4, 7 and 15, using a numerical scale from 0 to 10.ResultsBoth groups showed similar pain at postoperative day 4. At day 7, pain was higher in group 2 (P=.049), while at day 15 both groups showed only some discomfort. Sickness and vomiting was more frequent in group 1, and haemorrhage and hospitalisation in group 2. Cold dissection patients showed lower levels of pain at days 4 and 7, independently of analgesic protocol, and had lower haemorrhage and emergency visit rates.ConclusionsThe efficacy of both protocols was similar in terms of control of pain, with the exception of day 7; however, the protocol with prednisone showed fewer secondary effects. Patients operated using cold dissection had less pain and fewer complications.Copyright © 2013 Elsevier España, S.L. All rights reserved.

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