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Vol. 64. Issue 3.
Pages 211-216 (May - June 2013)
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Vol. 64. Issue 3.
Pages 211-216 (May - June 2013)
Original Article
Protocol for Post-tonsillectomy Pain Control in Outpatient Adults
Protocolo específico para el control del dolor postamigdalectomía en los adultos intervenidos en régimen ambulatorio
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María L. Magdalenaa,??
Corresponding author
luzcolloto@gmail.com

Corresponding author.
, Luisa Caragola, Antonio Soléb, Vanesa Suáreza, José A. Cilleroa, Juan P. Rodrigoa
a Unidad de Cirugía Mayor Ambulatoria, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
b Facultad de Medicina y Ciencias de la Salud de la Universidad de Oviedo, Oviedo, Asturias, Spain
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Figures (1)
Tables (4)
Table 1. Group Homogeneity.
Table 2. Frequency of Complications in Both Groups.
Table 3. Relationship Between Surgical Technique and the Variables Evaluated.
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Abstract
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=.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 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.

Keywords:
Tonsillectomy
Post-tonsillectomy haemorrhage
Postoperative complications
Postoperative pain
Nursing
Education and information
Resumen
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.

Palabras clave:
Amigdalectomía
Hemorragia postamigdalectomía
Complicaciones postoperatorias
Dolor postoperatorio
Enfermería
Educación e información

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