1 Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Tonsillectomy is one of the most frequently performed surgeries by otorhinolaryngologists globally. When performed with proper indications, tonsillectomies provide long-term improvements in health and quality of life. It is different from other surgical procedures because the wounds are left open to heal by secondary intention, thus the main complaint from patients after the surgery is severe pain. None of the modern surgery techniques stand out as superior when comparing their post-surgery pain levels. A wide variety of studies have been conducted where different types of pain-relieving medications were compared, however, to this day, there are no clear pain management guidelines after tonsillectomies. Acetaminophen and ibuprofen provide only a moderate relief of pain. Dexamethasone, when used in multimodal treatment, provides higher analgesia than the monotherapy of nonsteroid anti-inflammatory drugs. The research on opioid analgesics is very limited, yet available studies show, that it bestows excellent pain relief for patients after the removal of palatine tonsils with little to no adverse effects. Further research is needed to determine the most optimal course of action, providing an adequate pain management method for patients after tonsillectomies.
Keywords: postoperative pain management, tonsillectomy, surgical technique, pain medication.