ABSTRACT
BACKGROUND AND OBJECTIVE: Effective and early treatment of postoperative pain and nausea have become pivotal for the early discharge of patients after tonsillectomy. Opioid-based analgesia is standard practice but the use of non-steroidal anti-inflammatory drugs is discouraged due to their platelet inhibiting properties. The cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drugs are effective analgesics and do not affect platelet function. We hypothesized that premedication with cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug in addition to paracetamol would provide effective analgesia and decrease opioid consumption during early recovery from tonsillectomy. METHODS: In a randomized, placebo-controlled study of adult tonsillectomy patients (n=40) one group (R-group; n=20) was premedicated with paracetamol 1.5 g and rofecoxib 50 mg and a control group (P-group; n=20) was premedicated with paracetamol 1.5 g and placebo. Morphine was used as rescue medication. Postoperative (24 h) pain scores (0--10), morphine consumption as well as intraoperative blood loss were recorded. RESULTS: We found no overall difference in pain scores between the groups but significantly more patients in the placebo group had pain scores >5 within the first 8 h. The rofecoxib group consumed less morphine during the first 12 h. A lower intraoperative blood loss was observed in the rofecoxib group. CONCLUSION: Our results suggest an early although clinically minor analgesic benefit of the addition of a cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug to paracetamol as premedication for adult tonsillectomy.
Subject(s)
Acetaminophen/therapeutic use , Analgesics, Non-Narcotic/therapeutic use , Cyclooxygenase 2 Inhibitors/therapeutic use , Lactones/therapeutic use , Pain, Postoperative/drug therapy , Sulfones/therapeutic use , Tonsillectomy , Adolescent , Adult , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/therapeutic use , Double-Blind Method , Female , Humans , Male , Middle Aged , Pain Measurement , Preanesthetic MedicationABSTRACT
During a 5-month period in 1991 four infants with choanal atresia or stenosis were born at one hospital. We therefore reviewed our experience of this condition during the past 6 years and compared the patients who presented before with the four clustered cases. No definite explanation has been ascertained for this cluster of cases of choanal obstruction but a viral or other environmental teratogen could not be excluded.
