A prospective randomized double-blind trial of fibrin glue for reducing pain and bleeding after tonsillectomy

被引:26
作者
Segal, Nili [1 ,2 ]
Puterman, Moshe [1 ,2 ]
Rotem, Eran [3 ]
Niv, Alexander [1 ,2 ]
Kaplan, Daniel [1 ,2 ]
Kraus, Mordechai [1 ,2 ]
Brenner, Hilel [1 ,2 ]
Nash, Michael [1 ,2 ]
Tal, Asher [4 ]
Leiberman, Alberto [1 ,2 ]
机构
[1] Soroka Univ Med Ctr, Dept Otolaryngol, IL-84101 Beer Sheva, Israel
[2] Soroka Univ Med Ctr, Dept Head & Neck Surg, IL-84101 Beer Sheva, Israel
[3] Ben Gurion Univ Negev, Soroka Univ Med Ctr, Dept Radiol, Beer Sheva, Israel
[4] Ben Gurion Univ Negev, Soroka Univ Med Ctr, Dept Pediat, Beer Sheva, Israel
关键词
tonsillectomy; fibrin glue; post-tonsillectomy pain; post-tonsillectomy bleeding;
D O I
10.1016/j.ijporl.2007.12.011
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objectives: Varying surgical techniques as well as a large selection of analgesics and other medications have been evaluated over the years in the hopes of reducing post-tonsillectomy pain. Several publications in recent years have demonstrated the efficacy of fibrin glue in reducing post-tonsiltectomy bleeding and pain. The objectives of this study were to evaluate the effect of fibrin glue on pain and bleeding after tonsillectomy. Study design: A prospective randomized double-blind study was performed on 168 consecutive patients undergoing tonsillectomy for obstructive steep apnea and chronic tonsillitis. Methods: Patients were randomly assigned to the treatment protocol. In the study group, the tonsillar beds were coated with fibrin glue (Quixil, OMRIX biopharmaceuticals) at the end of the operation. Patients in the controlled group underwent tonsillectomy without the use of fibrin glue. The patients were then monitored for postoperative bleeding, and a patient-based pain assessment instrument was used to evaluate pain, ability to eat and analgesics consumption for 10 days after surgery. Results: Ninety-six patients returned for postoperative follow up and fitted in the questionnaire. As our medical center is the only hospital in the southern district of Israel and we hospitalize every person who presents with post-tonsillectomy bleeding, we can assume that any patient from either group who presented with post-tonsillectomy bleeding would be familiar to us. Analysis showed that no statistically significant differences relating to postoperative pain, bleeding, use of analgesics and postoperative eating resumption were detected between the patients treated with fibrin glue and controls. Conclusions: We cannot substantiate a significant beneficial effect of fibrin glue in post-tonsillectomy pain control, prevention of bleeding or facilitating eating and thus find no indication for the routine use of fibrin glue in tonsillectomy. (c) 2007 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:469 / 473
页数:5
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