Pain Related Secondary Outcomes Associated with Cold Tonsillectomy and Role of Topical Sucralfate in Mitigating Their Severity: A Comparative Observational Study

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The aim of the study was to assess the pain related secondary outcomes associated with cold tonsillectomy and role of topical sucralfate to reduce their intensity. Material and Methods: This comparative observational study was conducted in the ENT department of the Pakistan Institute of Medical Sciences (P.I.M.S.), affiliated with the Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, spanned from December 2016 to August 2017, following institutional ethical approval. The study comprised 112 patients with recurrent tonsillitis, evenly assigned to group A (subjects) and group B (control). Tonsillectomy, employing the cold steel dissection method, was administered to all patients. Group A received 10ml of topical sucralfate every 8 hours on the zero and first postoperative days, while group B received a placebo. Comparative analysis between the groups focused on pain-related secondary outcomes, including referred otalgia and the ability to initiate a regular oral diet on the morning of the first postoperative day. SPSS version 21 facilitated data analysis, with significance set at p < 0.005. Results: In group A, the mean age was 12.14±5.17, and in group B, it was 11.53±3.95, resulting in an overall mean age of 11.83±4.59 for both groups. Among 112 patients, 55.4% (n=62) were male, and 44.6% (n=50) were female. The frequency of referred earache was significantly lower in group A (15, 26.8%) compared to group B (25, 54.6%) [n1=n2=56, p=0.049]. Intolerance to start a normal diet was significantly lower in group A (17, 30.4%) compared to group B (39, 69.6%) at the first post-op day [n1=n2=56, p=0.034].Conclusion: Utilizing topical sucralfate alongside other pain management strategies proves to be an effective approach in reducing the intensity of pain related secondary complication i.e. referred otalgia and intolerance to oral intake among patients undergoing tonsillectomy using the cold steel dissection technique.