Abstract
Introduction: Pain in the post-operative period is a major concern following tonsillectomy in an adult resulting in prolonged hospital stay, decreased oral intake and absence from work. Various techniques and medications have been tried to reduce the pain.
 Objectives We attempted to study the efficacy of diclofenac gargle in reducing the post-tonsillectomy pain in adults.
 Methodology We conducted a double-blind randomized study in patients 18 years or older undergoing tonsillectomy. Cases were given diclofenac gargle in post-operative period whereas controls were given normal saline gargle. Other modality of treatment and medication were same in both the groups. Pain was assessed at rest and during swallowing with Visual Analogue Score (VAS) on first and second post-operative day, and then at the end of first and second week of the surgery. Pain scores between two groups were compared.
 Results There were 64 participants equally divided into cases and controls by block randomization. Pain score during swallowing was significantly less in cases. The difference at rest was not significant at any point of time studied. The pain gradually increased over a week in both the groups and then rapidly decreased by the end of second week.
 Conclusion Diclofenac gargle is effective in reducing the posttonsillectomy pain, especially during swallowing, in adults.
Highlights
Tonsillectomy is one of the most commonly performed surgery in otolaryngology
Diclofenac gargle is effec ve in reducing the posttonsillectomy pain, especially during swallowing, in adults
Is Diclofenac Gargle Effec ve in Allevia ng Post-tonsillectomy Pain in Adults? BJHS 2020;5(2)12: 1031-1034
Summary
Tonsillectomy is one of the most commonly performed surgery in otolaryngology. Post-opera ve pain management is an important aspect following tonsillectomy, especially in adults.[1]. Local injec on of anesthe c agents like lidocaine or bupivacaine, parenteral dexamethasone during induc on of anesthesia, non-steroidal an -inflammatory drugs (NSAIDs) like ketorolac or diclofenac, or opioids by various routes, local injec on of ketamine, and their combina ons are the most commonly used methods.[2,3] Other modali es to reduce the pain include applica on of hyaluronic acid in the tonsillar fossa a er surgery, covering up of tonsillar fossa with mucosal flaps or floseal etc.[4,5] Diclofenac has been used rou nely by dental doctors and is found to act as local anesthe c via various mechanism of ac on.[6] It has been commonly used by dental doctors but is rare in otolaryngology prac ce. We a empted to assess the efficacy of diclofenac gargle in allevia ng post-tonsillectomy pain in adults
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