Effect of tonsillar fossa cooling with cold saline on early post-tonsillectomy pain: A randomized, double-blind controlled study

Abstract

Postoperative pain following tonsillectomy is troublesome, and non-pharmacological methods can be a valuable adjunct to reduce the intensity of pain. Cooling can attenuate the damage done to tissues by hot dissection techniques.Thestudy was aimed to assess the effect of tonsillar fossa cooling on post-tonsillectomy pain. Forty patients aged 8-18 years of American Society of Anaesthesiologists physical status I and II scheduled for elective bilateral tonsillectomy with bipolar electrocautery under general anaesthesia were recruited. After obtaining consent and approval from the institutional ethical committee, they were randomly assigned to one of the two groups. At the end of tonsillectomy, the tonsillar fossa was packed for 10 minutes using gauze soaked in ice-cold 0.9% saline (5–10 ºC) in group T (test) and saline at room temperature in group C (control). The postoperative pain scores using Faces Pain Scale-Revised (FPS–R) and sore throat were evaluated at 15 minutes, 1 hour, 6 hours and 12 hours. All the data were analyzed using appropriate statistical tests. P < 0.05 was considered significant.Pain scores were significantly lower in group T as compared to group C at all time points. (p<0.05) The rescue analgesic consumption was lower in group T.(p<0.05) There was no difference in of sore throat between two groups. Cooling of the tonsillar fossa with ice-cold 0.9% saline after hot dissection tonsillectomy is a useful adjunct in reducing postoperative pain without any significant complications.