Complex evaluation of pain after tonsillectomy

Vaiman, Michael; Gavrieli, Haim

doi:10.1080/00016480601110204

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Although the VAS pain scale is statistically meaningful, it is a subjective tool, and thus, we suggest in future studies several pain assessment tests be used, such as, the memorial pain assessment card, the McGill pain Questionnaire, the Brief pain inventory, and others, to reduce individual differences. 16,21,22) The limitations of this study are as follows. First, the level of thermal injury in adjacent soft tissue depends on the degree of use of each diathermal instrument.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Randomized Comparative Study of Two Diathermy Power Settings for Monopolar Microdissection and Bipolar Hemostasis during Tonsillectomy

Baek¹,

Kim²,

Choi³

et al. 2016

Korean J Otorhinolaryngol-Head Neck Surg

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Background and ObjectivesZZOptimal electrical power required for diathermy during tonsillectomy has not been determined. The aim of this pilot study was to evaluate and compare surgical outcomes of using diathermy power settings at 15 watts (W) and 25W for monopolar microdissection and bipolar hemostasis during tonsillectomy. Subjects and MethodZZThis prospective, single-center, single-blind, randomized study was conducted on 92 patients who underwent 15W or 25W monopolar microdissection and bipolar hemostasis for tonsillectomy. Operation times, post-operative pain severities, and rates of hemorrhage were compared between the 15W and 25W groups. ResultsZZThe 92 patients were randomized equally into two study groups. The mean operation duration for the 15W group was significantly longer than in the 25W group (18.5±6.11 versus 13.4±6.04 minutes, p＜0.01). The rate of minimal hemorrhage (defined as an episode of bleeding not significant enough for hospital visitation) for the 15W group was significantly higher than for the 25W group (41.3% versus 20.5%, p＜0.05). No significant intergroup difference was observed between the rates of primary or secondary hemorrhage or postoperative pain scores. ConclusionZZTwenty-five watt monopolar microdissection and bipolar hemostasis for tonsillectomy had a shorter mean operation time and a lower post-operative minimal hemorrhage rate than 15W monopolar microdissection and bipolar hemostasis.

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Section: Discussionmentioning

confidence: 99%

A Pilot Randomized Comparative Study of Two Diathermy Power Settings for Monopolar Microdissection and Bipolar Hemostasis during Tonsillectomy

Baek¹,

Kim²,

Choi³

et al. 2016

Korean J Otorhinolaryngol-Head Neck Surg

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“…Surface EMG appeared to be very convenient tool for assessment of patients with both the oral and the pharyngeal dysphagia/odynophagia. Its sensitivity and specificity was proven in several previous works [ 21 - 26 ]. Since the surface EMG monitors the summed activity of large groups of muscle fibers, surface EMG recordings are repeatable.…”

Section: Discussionmentioning

confidence: 88%

Oral vs. pharyngeal dysphagia: surface electromyography randomized study

Vaiman

Nahlieli

2009

BMC Ear Nose Throat Disord

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Background: A clear differential diagnosis between oral and pharyngeal dysphagia remains an unsolved problem. Disorders of the oral cavity are frequently overlooked when dysphagia/ odybophagia complaints are assessed. Surface electromyographic (sEMG) studies were performed on randomly assigned patients with oral and pharyngeal pathology to evaluate their dysphagia complaints for the sake of differential diagnosis.Methods: Parameters evaluated during swallowing for patients after dental surgery (1: n = 62), oral infections (2: n = 49), acute tonsillitis (3: n = 66) and healthy controls (4: n = 50) included timing and amplitude of sEMG activity of masseter, infrahyoid and submental muscles.

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“…It is known that postsurgical dysphagia/odynophagia increases time needed for a single swallow [10,19]. It could be suggested (an additional study on healthy subjects is needed to prove this) that oxycodone due its opioid nature affects temporal relationships of the events of the swallowing cycle the same way.…”

Section: Discussionmentioning

confidence: 99%

“…Electromyography (EMG) of swallowing, however, might supply us with data helpful for both qualitative and quantitative assessment of analgesia. EMG reactivity in relation to pain was previously studied among patients following tonsillectomy [9,10], as well as among facial pain patients [11], and in patients with myogenous temporomandibular disorders (TMD) [12–14]. …”

Section: Introductionmentioning

confidence: 99%

Oxycodone and Dexamethasone for pain management after tonsillectomy: A placebo-controlled EMG assessed clinical trial

2011

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SummaryBackgroundSurface electromyographic (sEMG) study of post-tonsillectomy swallow-evoked muscular reactions was performed in order to evaluate the efficacy and safety of oxycodone and dexamethasone in pain management after tonsillectomy.Material/Methods90 randomly chosen operated adults were divided into three groups. Group 1 (n=30) was treated with OxyContin (Oxycodone) injections; Group 2 (n=30) was treated with Dexacort (Dexamethasone), and Group 3 (n=30) was a placebo group. Pain assessment included visual analogue scale (VAS) pain score and the EMG data like the timing, electric amplitude and graphic patterns of muscular activity during deglutition. We investigated masseter, infrahyoid and submental-submandibular muscles. Records from trapezius muscle were used for control. The results were compared with previously established normative database. The patients were tested 24 h after surgery. The sEMG data were compared with VAS pain score with regard to changes in clinical condition of the patients.ResultsAnalgesia with oxycodone smoothed the recorded sEMG swallow peaks and increases time of deglutition. Dexamethasone normalized muscular activity in deglutition in cases with edema as detected by the EMG records. Statistically significant difference in muscle reactions was detected between the two Groups and the placebo group.ConclusionsApplication of oxycodone significantly reduces the postoperative pain. Application of dexamethasone after tonsillectomy is advisable because of the reduction of postoperative morbidity while the reduction of the postoperative pain is secondary to the reduction of edema. SEMG might be used as an adjunctive measure of pain behavior via assessment of muscular reactions to pain and to analgesia.

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Complex evaluation of pain after tonsillectomy

Cited by 5 publications

References 14 publications

A Pilot Randomized Comparative Study of Two Diathermy Power Settings for Monopolar Microdissection and Bipolar Hemostasis during Tonsillectomy

A Pilot Randomized Comparative Study of Two Diathermy Power Settings for Monopolar Microdissection and Bipolar Hemostasis during Tonsillectomy

Oral vs. pharyngeal dysphagia: surface electromyography randomized study

Oxycodone and Dexamethasone for pain management after tonsillectomy: A placebo-controlled EMG assessed clinical trial

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