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Relief of pain and trismus in patients treated with naproxen or acetylsalicylic acid after tonsillectomy

Published online by Cambridge University Press:  29 June 2007

S. Kristensen ,
K. Tveteraas ,
P. Hein ,
H. B. Poulsen  and
K. E. Outzen
S. Kristensen*
Affiliation:
ENT Department, St. Joseph's Hospital, 6700 Esbjerg, Denmark.
K. Tveteraas
Affiliation:
ENT Department, St. Joseph's Hospital, 6700 Esbjerg, Denmark.
P. Hein
Affiliation:
Astra-Syntex Pharmaceuticals, 2000 Copenhagen, Denmark.
H. B. Poulsen
Affiliation:
ENT Department, Vejle Hospital, 7000 Vejle, Denmark.
K. E. Outzen
Affiliation:
ENT Department, Vejle Hospital, 7000 Vejle, Denmark.
*
Soeren Kristensen, M.D., Chief ENT Department, St. Joseph's Hospital, 6700 Esbjerg, Denmark.
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Abstract

The pain-relieving efficacy of naproxen and acetylsalicylic acid (ASA) in tonsillectomized patients was compared in a double blind parallel clinical trial comprising 83 patients, among whom 42 were treated with naproxen and 41 with ASA. The patients were treated post-operatively for two days with either naproxen suppositories 500 mg. twice, or ASA effervescent tablets 1000 mg. three times, daily.

The therapeutic gain was evaluated by recording the intensity of pain, reduced ability to open the mouth (trismus), consumption of supplementary analgesic (parcetamol), and pain-related sleep disturbances.

The statistical analysis of the results revealed no differences in pain intensity, consumption of additional analgesics or pain-related sleep disturbances in the two treatment groups. A considerable degree of trismus was demonstrated in most of the tonsillectomized patients. This reduced ability to open the mouth was gradually overcome in the naproxen group while it remained unchanged in the ASA group, however, no statistical significant difference could be demonstrated. Additionally, no significant positive correlation between pain intensity and trismus was proven. The pain-relieving effect, however, was unsatisfactory in both the naproxen and the ASA group, and clinical controlled trial studies of alternative analgetics in tonsillectomized patients are still to be encouraged.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 102 , Issue 1 , January 1988 , pp. 39 - 42
Copyright
Copyright © JLO (1984) Limited 1988

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References

Allen, R. T. (1953) New method for relieving postoperative pain following tonsillectomy. Archives of Otolaryngology, 57: 86.CrossRefGoogle ScholarPubMed
Anderson, H. A., Rice, B. J. and Cantrell, R. W. (1975) Effects of the injectd deposteroid on post-tonsillecmy morbidity. A double blind stud. Archives of Otolaryngology, 101: 86–88.CrossRefGoogle Scholar
Azuma, F., Itoh, J.Takeda, T. and Matsuoka, I. (1979) A double blind clinical trial of diclofenac sodium suppositories for pain and inflammation after tonsillectomy. Jibi Inokoka Rinsho, 72: 63–75.CrossRefGoogle Scholar
Brogden, R. N., Heel, R. C., Speight, T. M. and Avery, G. S. (1979) Naproxen up to date: A review of its pharmacological properties and therapeutic efficacy and use in rheumatic diseases and pain states. Drugs, 18: 241–277.CrossRefGoogle Scholar
Carric, D. G. (1984) Salicylates and post-tonsillectomy hemorhage. Journal of Layrngology and Otology, 98: 803–805.CrossRefGoogle Scholar
Davison, M., Boles, R. G. and Snyderman, S. C. (1952) A prolonged local anesthetic in control of post-tonsillectomy pain. Annals of Otology, Rhinology and Laryngology, 61: 1046–1047.CrossRefGoogle Scholar
Dommerby, H. and Rasmussen, O. R. (1984) Diclofenac (Volt-aren): Pain relieving effect after tonsillectom. Acta otolaryngolica, 98: 185–192.CrossRefGoogle Scholar
Huskisson, E. C. (1974) Measurement of pain. Lancet, II: 1127–1131.CrossRefGoogle Scholar
Kristensen, S. and Tveteraas, K. (1986) Review: The aetiology and pathogenesis of trismus. Clinical Otolaryngology, 11: (in press).Google Scholar
Mahler, D. L., Forrest, W. H., Brown, C. R., Shroff, P. F., Gordon, H. E., Brown, B. W. and James, K. E. (1976) Assay of aspirin and naproxen analgesia. Clinical Pharmacology and Therapeutics, 19: 18–23.CrossRefGoogle ScholarPubMed
McKenna, E. L. (1972) Distress after tonsillectomy. A clinical trial of injected pencillin anesthetic steroid mixture. Transactions of the American Academy of Ophthalmology and Otolaryngology, 25: 109–112.Google Scholar
Nadell, J., Bruno, J., Varady, J. and Segre, E. J. (1974) Effect of naproxen and of aspirin on bleeding time and platelet aggregation. Journal of Clinical Pharmacology, 14: 176–182.CrossRefGoogle ScholarPubMed
Papangelow, L. (1972) Hemostasis in tonsillectomy. A comparison of electrocoagulation and ligation. Archives of Otolaryngologv, 96: 358–360.CrossRefGoogle Scholar
Penn, S. E. (1952) Control of post-tonsillectomy pain. Archives of Otolaryngology, 56: 59–60.CrossRefGoogle ScholarPubMed
Raj, T. B. and Wickham, M. H. (1986) The effect of benzydamine hydrochloride (difflam) spray on post-tonsillectomy symptoms: A double blind study. Journal of Laryngology and Otology, 100: 303–306.CrossRefGoogle ScholarPubMed
Reed, G. f. and Montgomery, W. W. (1955) The efficacy of efocaine in tonsillectomized patients. Archives of Otolaryngology, 62: 490–492.CrossRefGoogle ScholarPubMed
Ritter, F. N. and Fink, J. A. (1972) Electrocoagulation for the control of bleeding at adenotonsillectomy. Pros and cons. Transactions of the American Academy of Ophthalmology and Otolaryngology, 76: 1340–1345.Google ScholarPubMed
Roy, A., Delarosa, C. and Vecchio, Y. A. (1976) Bleeding following tonsillectomy. A study of electrocoagulation and ligation techniques. Archives of Otolaryngology, 102: 9–10.CrossRefGoogle ScholarPubMed
Ruedy, J. (1973) A comparison of the analgesic efficacy of naproxen and acetylsalicylic acid—codeine in patients with pain after dental surgery. Scandinavian Journal of Rheumatology, Supplementum 2: 60–63.CrossRefGoogle ScholarPubMed
Saarnivaara, L., Metsa-Ketela, T., Mannisto, P. and Vapaatalo, H. (1980) Pain relief and sputumn prostaglandins in adults treated with pethidine, tilidine and indomethacine after tonsillectomy. A double blind study. Acta Anaesthesiologica Scandinavia, 24: 79–85.CrossRefGoogle ScholarPubMed
Sacchetti, G., Ferrati, G. C., Parinello, L. and Salami, A. (1978) Kinetics of analgesic response in man. An example with two non-steroidal anti-inflammatory analgesic drugs. Journal of Internatioanl Medical Research, 6: 312–316.Google Scholar
Schiff, M. (1982) Chewing gum and tonsillectomy. Laryngoscope, 92: 820.CrossRefGoogle ScholarPubMed
Schousboe, H. H. and Aastrup, J. E. (1976) Clinical results of cryosurgery in recurrent acute tonsillitis. Journal of Laryngology and Otology, 90: 795–799.Google ScholarPubMed
Sindet-Pedersen, S., Kølsen Petersen, J., Goetzsche, P. c. and Christensen, H. (1986) A double blind, randomized study of naproxen and acetylsalicylic acid after surgical removal of impacted lower third molars. International Journal of Oral and Maxillofacial Surgery, 15: 1–6.CrossRefGoogle ScholarPubMed
Stetson, J. B., Robinson, K., Wardell, W. M. and Lasagna, L. (1973) Analgesic activity of oral naproxen in patients with postoperative pain. Scandinavian Journal of Rheumatology, Supplementum 2: 50–55.CrossRefGoogle ScholarPubMed
Strohm, H. (1974) Acupuncture treatment of post-tonsillectomy pain. The analgesic effect compared wtih blind puncture. Ugeskrift for Laeger, 136: 1855–1856.Google Scholar
Weighill, J. S., Proops, D. W., Jeffries, D. and Brandrick, J. (1986) Pain relief following tonsillectomy. Does sewing the faucial pillars together help? Journal of Laryngology and Otology, 100: 307–310.CrossRefGoogle ScholarPubMed
Weligodapola, G. s. (1983) Comparative study of tonsillectomy performed by guillotine and dissection methods. Journal of Laryngology and Otology, 97: 605–606.CrossRefGoogle ScholarPubMed