Protocolo específico para el control del dolor postamigdalectomía en los adultos intervenidos en régimen ambulatorio / Protocol for post-tonsillectomy pain control in outpatient adults

Introducción: Aunque en los últimos años se han producido notables avances en las técnicas anestésicas y quirúrgicas, la morbilidad asociada a la amigdalectomía y especialmente el dolor, sigue siendo un importante problema clínico. Objetivos: Evaluar la influencia del protocolo específico para el control del dolor postoperatorio y comparar la frecuencia de complicaciones en los pacientes con protocolo y sin él. Métodos: Estudio descriptivo, observacional y prospectivo. Pacientes adultos amigdalectomizados en régimen ambulatorio. Dos grupos: grupo 1: 65 pacientes a los cuales se les entregó un tratamiento analgésico variable; grupo 2: 50 pacientes con protocolo analgésico y entrevista preoperatoria de enfermería. Para la valoración del dolor se utilizó la Escala Numérica de 0 a 10. Las técnicas quirúrgicas: disección fría o electrobisturí. Resultados: Al cuarto día, el grupo 1(sin protocolo) presentó una media de 4,8 puntos en la Escala Numérica de 0 a 10 para evaluación del dolor; el grupo 2 (con protocolo) presentó una media de 3, p=0,0002. Del grupo 1, 22 pacientes (36%) acudieron a Urgencias, del grupo 2 acudieron 8 pacientes (16%), p=0,019. Al cuarto día los pacientes intervenidos con disección fría presentaron 3,7 puntos en la Escala Numérica de 0 a 10, frente a los intervenidos con electrobisturí que presentaron 4,4 puntos. Conclusiones: Un protocolo específico en pacientes adultos intervenidos de amigdalectomía en régimen ambulatorio es útil para conseguir que los pacientes presenten menor dolor y complicaciones (AU)

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 4th 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=0.0002). From group 1, 22 patients (36%) had to go to the emergency service, while 8 (16%) in group 2 did so (P=0.019). On the 4th 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 (AU)

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.