Various Methods of Pain Control Post-Tonsillectomy: A Prospective Comparative Study

Introduction: Postoperative pain post Tonsillectomy and difficulty in swallowing prevent a child to return to regular diet resulting in dehydration and prolonged hospital stay. Post tonsillectomy is ranked among the 25 most painful surgical procedures ever performed acccording to a research in 2013. Materials and Methods: Simple random sampling was used and 80 patients were assigned into 2 groups - 40 in Group A received 1 puff of Topical 10% Lignocaine spray in the Fossa at set intervals and 40 in Group B received a dose controlled Intramuscular Paracetamol (15mg/kg body weight in divided doses) at the same intervals. Wong Baker pain score was noted twice a day and the particular drug was administred immediately after for 3 days. Obervations and Results: From the 1st post-operative day to the 3rd post-operative day, the pain score improved by 60.48% in Group A and 54.13% in Group B. Although the pain improves in both groups the p-value is far more significant in Group A (0.01) as compared to Group B (0.02). Discussion: Even after extensive studies done in the past, there is no hard and fast rule about what drugs to use post tonsillecomy. Various past studies have commented on the use of NSAIDs, Anaesthetics, Opiods, Non-opioids in the management of post-tonsillectomy pain. Our study is also in accordace with the past findings wherein pain improved in all groups of agents used. Conclusion: Pain after tonsillectomy is a significant morbidity which causes prolonged intensive care unit/hospital stay and affects the quality of life. In this study, we found that topical lignocaine performs better than intramuscular paracetamol in the management of post tonsillectomy pain.