Protocol for post-tonsillectomy pain control in outpatient adults.

INTRODUCTION Even though notable advances in anaesthetic and surgical techniques have appeared in recent years, morbidity, and especially pain, associated with tonsillectomy is still an important clinical problem. OBJECTIVES Assess the influence of a specific protocol for the control of postoperative pain and compare the frequency of complications in patients with and without it. METHODS This was a descriptive, observational and prospective study on adult tonsillectomy patients in outpatient surgery. There were 2 groups: group 1, with 65 patients to whom a variable analgesic treatment was given; and group 2, with 50 patients with analgesic protocol and preoperative nursing interview. For the evaluation of pain, a numerical scale from 0 to 10 was used. The surgical techniques used were cold dissection or electric dissection. RESULTS On the 4(th) day, group 1 (without protocol) presented a mean pain of 4.8 points on a numerical scale from 0 to 10, while group 2 (with protocol) presented mean of 3 (P=.0002). From group 1, 22 patients (36%) had to go to the emergency service, while 8 (16%) in group 2 did so (P=.019). On the 4(th) day, patients operated with cold dissection presented 3.7 points, as opposed to those operated with electric dissection, who presented 4.4 points. CONCLUSIONS A specific protocol applied to adult tonsillectomy patients in outpatient surgery is useful to obtain less pain and fewer complications.