[Actual considerations of post-tonsillectomy case management]

[About new possibilities for optimizing the postoperative period in tonsillectomy]

Tonsillectomy is one of the most frequent surgical interventions in otorhinolaryngology. This surgical is always accompanied by the development of reactive inflammatory phenomena and pain syndrome. The effectiveness and safety of tonsillectomy can be improved through the use of topical treatment in the postoperative period, including antiseptics in the form of a spray. An observational study was conducted at the Department of Otorhinolaryngology of the Russian University of Medicine of the Ministry of Health of the Russian Federation, the purpose of which was to evaluate the clinical efficacy, tolerability and safety of Viroxynol for oral and throat mucosa in patients after tonsillectomy. As a result of the analysis of the data obtained, it was found that the use of Viroxynol for the mucous membrane of the oral cavity and throat in the treatment of patients in the early postoperative period causes a pronounced clinical effect, reduces the need for additional medications, allows faster reduction of pain syndrome against the background of relief of reactive inflammatory phenomena, improves the quality of life of patients, accelerates the healing process, reduces the risk of bacterial inflammation. The drug may be recommended for use in patients after tonsillectomy.

[Comparison of pain after laser and traditional extracapsular tonsillectomy]

OBJECTIVE

To compare the pain during the postoperative period after the extracapsular tonsillectomy, performed with the 1.94 µm laser and cold steel tonsillectomy.

MATERIAL AND METHODS

Sixty patients with chronic decompensated tonsillitis were enrolled in the study. Patients were randomized into two groups: the first one was subjected to cold steel tonsillectomy; in the second group tonsillectomy was done using a laser with 1.94 µm wavelength at pulsed mode. Patients' anamnesis was evaluated (the presence of signs of a toxic-allergic form of the disease, peritonsillar abscesses, the duration of the disease and the frequency of exacerbations of tonsillitis per year). In the postoperative period patients filled out questionnaires: the severity of pain was assessed for 10 days in points from 0 to 10, and painkiller use frequency per day.

RESULTS

Statistical analysis revealed that the pain after tonsillectomy depends on the presence of peritonsillar abscesses in the anamnesis. In patients with abscesses, the pain and the need for anesthesia are significantly lower with the laser technique compared with cold steel. The tonsillectomy technique does not affect the risk of postoperative bleeding (in both groups - 1/30).

CONCLUSION

The postoperative period after extracapsular laser tonsillectomy is characterized by significantly less pain than traditional tonsillectomy with cold instruments in patients with a history of peritonsillar abscess. Laser tonsillectomy does not have an increased risk of bleeding compared to traditional tonsillectomy.

Use of Homeopathic Arnica montana 30cH for Postoperative Analgesia in Female Dogs Undergoing Elective Ovariohysterectomy

BACKGROUND

 Ovariohysterectomy (OH) is one of the most frequent elective surgical procedures in routine veterinary practice. Arnica montana is a well-known medicine in phytotherapy, with proven analgesic, anti-inflammatory, antiseptic, healing, antioxidant and immunomodulatory activity. However, there is still a shortage of studies on the action and effects of the homeopathic formulation of the medicine on animals. The aim of this study was to evaluate analgesia with Arnica montana 30cH during the postoperative period after elective OH.

METHODS

 Thirty healthy female dogs, aged 1 to 3 years, weighing 7 to 14 kg, were selected at the Veterinary Hospital in Campo Mourão, Paraná, Brazil. The dogs underwent the surgical procedure with an anaesthetic protocol and analgesia that had the aim of maintaining the patient's wellbeing. After the procedure, they were randomly divided into three groups of 10. One group received Arnica montana 30cH; another received 5% hydroalcoholic solution; and the third group, 0.9% NaCl saline solution. All animals received four drops of the respective solution sublingually and under blinded conditions, every 10 minutes for 1 hour, after the inhalational anaesthetic had been withdrawn. The Glasgow Composite Measure Pain Scale was used to analyse the effect of therapy. Analysis of variance (ANOVA) followed by the Tukey test was used to evaluate the test data. Statistical differences were deemed significant when p ≤0.05.

RESULTS

 The Arnica montana 30cH group maintained analgesia on average for 17.8 ± 3.6 hours, whilst the hydroalcoholic solution group did so for 5.1 ± 1.2 hours and the saline solution group for 4.1 ± 0.9 hours (p ≤0.05).

CONCLUSION

 These data demonstrate that Arnica montana 30cH presented a more significant analgesic effect than the control groups, thus indicating its potential for postoperative analgesia in dogs undergoing OH.