Pain on the first postoperative day after tonsillectomy in adults: A comparison of metamizole versus etoricoxib as baseline analgesic.
PLoS One
; 14(8): e0221188, 2019.
Article
en En
| MEDLINE
| ID: mdl-31412091
ABSTRACT
OBJECTIVE:
To compare the effect of metamizole versus etoricoxib as baseline analgesic for treating postoperative pain after tonsillectomy.DESIGN:
Single centre prospective cohort study.SETTING:
Two consecutive cohorts of tonsillectomy patients.PARTICIPANTS:
124 patients (n = 55 treated with etoricoxib, n = 69 with metamizole); median age 30.5 years; 50% women. MAIN OUTCOMEMEASURES:
Patients rated their pain on first postoperative day using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including numeric rating scales (NRS, 0-10) for pain determination. The influence of preoperative and postoperative parameters on patients' pain was estimated by univariate and multivariate statistical analysis.RESULTS:
The demographic parameters showed no differences between the patients in the metamizole group and the etoricoxib group (all p>0.05) with one exception Patients in the metamizole group had significantly more preoperative pain than patients in the etoricoxib group (p = 0.001). The metamizole group had a mean postoperative pain in activity of 4.4 ± 2.1 and the etoricoxib group of 4.5 ± 2.2. Maximal pain for the metamizole group and the etoricoxib group were 5.6 ± 2.2 and 6.1 ± 1.9, respectively. Pain in activity, maximal pain and minimal pain were not different between both groups (p = 0.652, p = 0.113, p = 0.276, respectively). Patients of the etoricoxib group received more frequently piritramide in recovery room as demand medication (p = 0.046). In the whole cohort, patients with peritonsillar abscess had more preoperative pain in comparison to chronic tonsillitis (p<0.001). Patients under 30.5 years reported higher maximal pain than older patients (p = 0.049). On the other hand, a significant influence of patients' age on the pain in activity and minimal pain could not be demonstrated (p = 0.368, p = 0.508, respectively). Men reported lower minimal pain than women (p = 0.041). Also, patients with ASA status I had lower minimal pain than patients with higher ASA status (p = 0.019). The multivariate analysis did not show an association between postoperative pain in activity and preoperative counseling on postoperative pain management (p = 0.588, p = 0.174, respectively). Special preoperative counseling on postoperative pain management resulted in lower levels of maximal pain (p = 0.024). Linear regression demonstrated an independent association of higher pain in activity with higher mobility impairment (p = 0.034) and respiratory impairment (p = 0.002). The linear regression of minimal pain identified female gender (p = 0.005) as an independent influencing factor with higher pain levels. In terms of satisfaction, no preoperative pain therapy (p = 0.016) could be found as an independently significant influencing factor with higher satisfaction.CONCLUSION:
Etoricoxib does not have an advantage as baseline analgesic for post tonsillectomy pain in comparison to metamizole.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Tonsilectomía
/
Tonsilitis
/
Dipirona
/
Etoricoxib
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Alemania