Natural course of tonsillectomy pain: A prospective patient cohort study

Abstract

Objective: The aim of this study was to determine the natural course of pain after tonsillectomy. Methods: This study included 119 patients that underwent tonsillectomy between November 2013 and November 2015. After undergoing tonsillectomy, patients scored their pain using the visual analogue scale three times daily (morning, midday, and evening) for 2 weeks. A linear mixed model was used for statistical analyses. Results: Increasing postoperative days was negatively associated with pain following tonsillectomy surgery (estimated value [EV] of visual analogue score [VAS]/day = -0.42, 95% confidence interval [CI] = -0.43 to -0.41, P < 0.001); the post-tonsillectomy pain curve illustrated this negative correlation. Postoperative pain was less in children and adolescents (<= 18 years old) than in adults (>18 years old) (EV = -0.81, 95% CI = -1.56 to -0.08, P = 0.031). Mean tonsillectomy-associated pain on postoperative day 1 was 6.4 VAS. It decreased slightly to 5.3 VAS until postoperative day 7, after which it reduced sharply to 3.7 VAS within 3 days; on postoperative day 14 it had decreased to 1.6 VAS. Pain assessments were higher in the morning (EV = 0.59, 95% CI = 0.50 to 0.69, P < 0.001) compared with assessments conducted in the evening. Conclusion: The natural course of postoperative tonsillectomy pain follows a gradual decline for I week after surgery, but decreases more rapidly after this period. (C) 2018 Elsevier B.V. All rights reserved.