Our Summary

This research paper is about improving the outcomes of tonsil removal surgery (tonsillectomy) by adding certain drugs to the local anaesthetic used in the procedure. The researchers looked at studies published up to August 2016, where the effects of local anaesthetics with added drugs were compared to those of local anaesthetics used alone. From their analysis of 11 trials involving 854 patients, they found that adding dexamethasone, magnesium, pethidine and tramadol to the local anaesthetic could help reduce pain and the need for painkillers after surgery. Dexamethasone in particular was found to significantly reduce post-operative nausea and vomiting, while magnesium was found to significantly reduce the incidence of laryngospasm (a potentially lethal complication where the voice box spasms and makes it hard to breathe). The evidence was strong enough to recommend adding magnesium to the anaesthetic to reduce the risk of laryngospasm.

FAQs

  1. What is the main focus of the research paper on tonsillectomy?
  2. What drugs were found to be beneficial when added to the local anaesthetic used in a tonsillectomy?
  3. How does adding magnesium to the local anaesthetic impact the outcome of a tonsillectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tonsillectomy is to discuss with your healthcare provider the possibility of adding certain drugs to the local anaesthetic used in the procedure, such as dexamethasone, magnesium, pethidine, and tramadol. These drugs have been found to help reduce pain, the need for painkillers, post-operative nausea and vomiting, and the risk of complications like laryngospasm. It’s important to have a conversation with your doctor about all the options available to improve your recovery and outcomes after tonsillectomy.

Suitable For

Patients who are typically recommended for tonsillectomy include those who experience frequent and severe throat infections, sleep-disordered breathing, or enlarged tonsils causing difficulty breathing or swallowing. Additionally, individuals with recurrent tonsillitis, tonsil stones, or cancer of the tonsils may also be candidates for the procedure. It is important for patients to discuss their symptoms and medical history with their healthcare provider to determine if tonsillectomy is the appropriate treatment option for them.

Timeline

Before tonsillectomy:

  1. Patient meets with an ear, nose, and throat (ENT) specialist to discuss the need for tonsillectomy and potential risks and benefits.
  2. Patient undergoes pre-operative testing, including blood work and physical examination.
  3. Patient is instructed to avoid certain medications and foods leading up to the surgery.
  4. On the day of surgery, patient is admitted to the hospital or surgical center and prepared for the procedure.

After tonsillectomy:

  1. Patient wakes up in the recovery room with a sore throat and may experience some discomfort.
  2. Patient is monitored for any signs of complications, such as bleeding or difficulty breathing.
  3. Patient is given pain medication as needed to manage post-operative pain.
  4. Patient is discharged home with instructions on how to care for the surgical site and manage pain.
  5. Patient follows up with the ENT specialist for a post-operative visit to ensure proper healing and address any concerns.
  6. Over the next few weeks, patient gradually recovers from surgery, with improvement in symptoms such as sore throat and difficulty swallowing.
  7. Patient may experience some temporary changes in taste or voice as the throat heals.
  8. Patient returns to normal activities and diet as directed by the healthcare provider.

What to Ask Your Doctor

  1. Can adding dexamethasone, magnesium, pethidine, or tramadol to the local anaesthetic during my tonsillectomy procedure help reduce pain and the need for painkillers afterwards?

  2. How do these added drugs work to improve outcomes after tonsillectomy surgery?

  3. What are the potential side effects or risks associated with adding these drugs to the local anaesthetic?

  4. Will adding these drugs affect my recovery time or the overall success of the surgery?

  5. Are there any specific factors or conditions that would make me a good candidate for adding these drugs to my tonsillectomy procedure?

  6. How will the addition of these drugs be incorporated into my treatment plan and monitored during and after the surgery?

  7. Are there any alternative pain management strategies or medications that could be considered instead of or in addition to these drugs?

  8. How long can I expect the effects of these added drugs to last after the surgery?

  9. Will adding these drugs to the local anaesthetic have any impact on my post-operative care or follow-up appointments?

  10. Is there any additional research or evidence supporting the use of these drugs in tonsillectomy surgery that I should be aware of?

Reference

Authors: Vlok R, Melhuish TM, Chong C, Ryan T, White LD. Journal: J Anesth. 2017 Aug;31(4):608-616. doi: 10.1007/s00540-017-2310-x. Epub 2017 Jan 24. PMID: 28120104