Is the systemic inflammatory reaction to surgery responsible for post-operative pain after tonsillectomy, and is it 'technique-related'?
| Autor: | Zeljka Roje, Goran Račić, Goran Kardum, Mirnes Selimović |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment media_common.quotation_subject Analgesic Tonsillitis Postoperative Hemorrhage Electrocoagulation medicine Humans Single-Blind Method Prospective Studies Child Prospective cohort study Tonsillectomy media_common Pain Postoperative biology business.industry Convalescence C-reactive protein General Medicine Airway obstruction medicine.disease Systemic Inflammatory Response Syndrome Surgery Airway Obstruction Systemic inflammatory response syndrome C-Reactive Protein Child Preschool Anesthesia Chronic Disease biology.protein Female business |
| Zdroj: | Wiener klinische Wochenschrift. 123:479-484 |
| ISSN: | 1613-7671 0043-5325 |
| Popis: | AIMS: Investigate the influence of operative technique on post-operative morbidity and the systemic inflammatory response after tonsillectomy. In addition, our aim was to compare the systemic inflammatory reaction, post-operative pain severity, and required time before the resumption of normal physical activity between two groups of tonsillectomized children and to correlate characteristics of the systemic inflammatory reaction to post-operative morbidity. PARTICIPANTS AND METHODS: This prospective, randomized, and single-blind study included 100 children between the ages of 3–16 years and who were scheduled for a tonsillectomy at our department for chronic tonsillitis and/or respiratory obstruction. The children were randomly assigned into one of two groups: either a conventional tonsillectomy with bipolar diathermy coagulation or a radiofrequency tonsillectomy procedure; both groups had a 14-day follow-up. We investigated the severity and duration of postoperative pain (based on the use of analgesics during the postoperative period), the postoperative day that they resumed normal physical activity, and the rate of postoperative hemorrhage. In order to assess the systemic inflammatory response, serum C-reactive protein (CRP) levels were measured before the surgery and seven days after the procedure. RESULTS: After the surgery CRP levels increased to a statistically significant level (t = –4.7; p < 0.001) in conventional tonsillectomy group. There was a statistically significant correlation between increased blood CRP levels after the surgery and the level of post-operative analgesic consumption, which was based on an increased number of analgesic applications (r = 0.28; p < 0.01) and a greater number of days in which analgesics were consumed (r = 0.26; p < 0.01). There was also a correlation between increased blood CRP levels and a longer required time to resume normal physical activities (r = 0.30; p < 0.01). CONCLUSION: Post-operative morbidity after tonsillectomy appears to depend on the systemic inflammatory response to surgery. This response is "technique-related," wherein a less-aggressive surgical technique produces a weaker post-operative inflammatory response and less post-operative morbidity. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink