Factors associated with moderate to severe pain in post-anesthesia care unit after Tonsillectomy: A retrospective study

Abstract

Background: Tonsillectomy can cause high intensity of pain and inadequate pain control might lead to eating problems. However, usage of opioids and non-steroidal anti-inflammatory drugs for postoperative analgesia is limited due to patients' comorbidities such as obstructive sleep apnea and risk of postoperative bleeding. Objective: To define the incidence of moderate to severe pain after tonsillectomy and associated factors. Materials and Methods: Electronic medical records of patients age 17 or older undergoing tonsillectomy between March 2014 and December 2018 were retrospectively reviewed. The collected data included patient data, surgical data, pain scores in the post-anesthesia care unit (PACU), and perioperative pain management. Results: Three hundred twenty-three patients were included. The mean age was 34.9±12.9 years, mean body mass index was 24.8±5.7 kg/m2 and 65% were female. The incidence of moderate (numeric rating scale [NRS], (0 to 10) of 4 to 6) to severe pain (NRS of 7 or more) in the PACU was 63.8%. Multivariate analysis revealed that not receiving intraoperative dexamethasone was the only factor associated with moderate to severe pain (adjusted OR 2.21, 95% CI 1.34 to 3.65) in the PACU. Conclusion: Moderate to severe pain after tonsillectomy was found in 63.8% of patients in the PACU and not giving intraoperative dexamethasone was a significant risk factor.