A Paganelli1, S Ayari Khalfallah2, A Brunaud3, I Constant4, V Deramoudt5, P Fayoux6, A Giovanni7, C Mareau8, R Marianowski9, J Michel7, M Mondain10, P Schultz11, J-M Treluyer12, C Wood13, S Pondaven14, R Nicollas15. 1. Service d'ORL et de chirurgie cervico-faciale, CHRU La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. Electronic address: arnaud.paganelli@ap-hm.fr. 2. Service d'ORL et de chirurgie cervico-faciale pédiatrique, hôpital Mère-Enfant, hospices civils de Lyon, 65, boulevard Pinel, 69500 Bron, France. 3. Centre médical Alpha 128, 128, avenue des Champs-Lasniers, 91940 Les Ulis, France. 4. Hôpital Armand-Trousseau, GHUEP, UMPC, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France. 5. Service d'ORL, hôpital Pontchaillou, CHRU de Rennes, rue Henri-Le-Guilloux, 35033 Rennes, France. 6. Service d'ORL et de chirurgie cervico-faciale pédiatrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille, France. 7. Service d'ORL et de chirurgie cervico-faciale, CHRU La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. 8. Centre douleur chronique, CHRU La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. 9. Service d'ORL et de chirurgie cervico-faciale, CHRU de Brest, 5, avenue Foch, 29200 Brest, France. 10. Département d'ORL, CHRU de Montpellier, 34295 Montpellier cedex 5, France. 11. Service d'ORL et de chirurgie cervico-faciale, hôpital Hautepierre, CHRU de Strasbourg, 1, avenue Maline, 67098 Strasbourg, France. 12. Université Paris Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France. 13. Centre de prise en charge de la douleur chronique, CHRU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France. 14. Service d'ORL pédiatrique, hôpital Clocheville, 49, boulevard Beranger, 37000 Tours, France. 15. Service d'ORL et de chirurgie cervico-faciale pédiatrique, CHRU La Timone - Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
Abstract
OBJECTIVES: The present clinical practice guidelines cover the entire field of management of post-tonsillectomy pain. Given the French and European regulatory restrictions on the use of codeine, an update appears necessary to clarify the management of post-tonsillectomy pain in adults. METHOD: A work group approached the issue of pain management, following the chronological pathway from initial consultation to postoperative period. As exhaustive a study of the literature as possible assessed the pain impact of the various surgical techniques and the efficacy of the various analgesia schedules. RESULTS: Guidelines on the management of post-tonsillectomy pain in adults were drawn up and graded, based on the levels of evidence of selected articles and on work group consensus. The guidelines stress the importance of patient information and seek to harmonize practice, reduce the risk of postoperative complications and above all improve control of post-tonsillectomy pain in adults.
OBJECTIVES: The present clinical practice guidelines cover the entire field of management of post-tonsillectomy pain. Given the French and European regulatory restrictions on the use of codeine, an update appears necessary to clarify the management of post-tonsillectomy pain in adults. METHOD: A work group approached the issue of pain management, following the chronological pathway from initial consultation to postoperative period. As exhaustive a study of the literature as possible assessed the pain impact of the various surgical techniques and the efficacy of the various analgesia schedules. RESULTS: Guidelines on the management of post-tonsillectomy pain in adults were drawn up and graded, based on the levels of evidence of selected articles and on work group consensus. The guidelines stress the importance of patient information and seek to harmonize practice, reduce the risk of postoperative complications and above all improve control of post-tonsillectomy pain in adults.