Therapy of postoperative pain after tonsillectomy in adults: comparison between Metamizol and Etoricoxib with QUIPS

Introduction:

Tonsillectomy is a frequent and painful procedure in ENT department. To improve the pain therapy in ENT department of University Hospital Jena basic analgesic with metamizole versus COX-2 inhibitor etoricoxib was investigated with the outcome-oriented benchmark project QUIPS (quality improvement in postoperative pain therapy). QUIPS uses Numerical Rating Scales (NRS) for pain measurement (0 = no pain, 10 = maximum pain).

Material/Methods:

Between November 2008 and May 2009 and February and December 2013, 124 patients (62 women, 62 men) were examined after tonsillectomy. 69 patients received metamizole and 55 patients etoricoxib. The average age was 33 ± 12 years (median 18 – 68 years). A bilateral tonsillectomy was performed in 76 patients due to acute recurrent tonsillitis and in 48 patients due to peritonsillar abscess.

Results:

Mean NRS pain scores on the 1st postoperative day were 4.5 ± 2.1 for exercise pain and 5.8 ± 2.1 for maximal pain above the intervention limit of 4. Only the mean minimal pain averaged at 2.3 ± 1.6. A significant reduction of the three pain parameters by administration of etoricoxib compared to metamizole as the basal analgesia could not be demonstrated (p = 0.652, p = 0.113, p = 0.276, respectively).

Conclusion:

The use of etoricoxib as the basic analgesia did not show any benefit compared to metamizole.

Publication History

Publication Date:
23 April 2019 (online)