Factors Associated with Moderate to Severe Pain in Post-
Anesthesia Care Unit after Tonsillectomy: A Retrospective
Study
Nuanprae Kitisin MD¹, Saowapark Chumpathong MD¹, Nattaya Raykateeraroj MD¹, Pichchaporn Praserdvigai MD¹, Matula Tareerath BN¹
Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Tonsillectomy can cause high intensity of pain and inadequate pain control might lead to eating problems. However, usage of opioids
and non-steroidal anti-inflammatory drugs for postoperative analgesia is limited due to patients’ comorbidities such as obstructive sleep apnea
and risk of postoperative bleeding.
Objective : To define the incidence of moderate to severe pain after tonsillectomy and associated factors.
Materials and Methods : Electronic medical records of patients age 17 or older undergoing tonsillectomy between March 2014 and December 2018 were retrospectively reviewed. The collected data included patient data, surgical data, pain scores in the post-anesthesia care unit (PACU), and perioperative pain management.
Results : Three hundred twenty-three patients were included. The mean age was 34.9±12.9 years, mean body mass index was 24.8±5.7 kg/m², and 65% were female. The incidence of moderate (numeric rating scale [NRS], (0 to 10) of 4 to 6) to severe pain (NRS of 7 or more) in the PACU was 63.8%. Multivariate analysis revealed that not receiving intraoperative dexamethasone was the only factor associated with moderate to severe pain (adjusted OR 2.21, 95% CI 1.34 to 3.65) in the PACU.
Conclusion : Moderate to severe pain after tonsillectomy was found in 63.8% of patients in the PACU and not giving intraoperative dexamethasone was a significant risk factor.
Received 24 August 2020 | Revised 21 October 2020 | Accepted 29 October 2020
doi.org/10.35755/jmedassocthai.2021.03.11864
Keywords :
Keywords : Risk factor, Post-anesthesia care unit, Tonsillectomy, Dexamethasone, Postoperative pain
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