JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v4i3.2346 jpsim.v4i3.2346 Original Research A Randomized Control Study on Primary Outcomes and the Effectiveness of Topical Sucralfate to Reduce Post-Tonsillectomy Throat Pain Momand Sadaqat Zeb Momina vazim4847@gmail.com * Arshad Minahil Department of ENT, Nangarhar University Teaching Hospital, Jalalabad- Afghanistan Department of ENT & HNS, Pakistan Institute of Medical Sciences, Islamabad-Pakistan *Correspondence: Momina Zeb (vazim4847@gmail.com) 25 09 2023 2023 4 3 228 232 19 05 2023 07 07 2023 Copyright © 2023 The Author(s) 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

The objective of the study was to assess the effectiveness of topical sucralfate to reduce post-tonsillectomy throat pain and associated primary outcomes.

 Methodology

This randomized control study was conducted in the department of ENT, Pakistan Institute of Medical Sciences (P.I.M.S.), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad from December 2016 to August 2017. The ethical approval was obtained from the ethical committee of the institution. One hundred and twelve patients having recurrent tonsillitis or hypertrophied tonsils were equally distributed into twin clusters. All the patients experienced tonsillectomy procedure (cold dissection method). The participants in-group A maintained on 10ml topical sucralfate (8 hourly during zero and first post-operative days) whereas the participants in-group B maintained on placebo. A comparison of both thestudy groups was done for post-tonsillectomy throat pain score as primary outcome, at zero and first post-operative days, as well as for the intolerance of tkaing normal oral diet at the morning of first post-operative day as secondary outcomes. Data was analyzed using SPSS version 21. A p value

 Results

The mean age of the study participants in group A was 12.14+5.17 whereas, in group B, it was recorded as 11.53+3.95. The overall mean age of both the groups participants was calculated as 11.83+4.59. Out of 112 patients, 55.4% (n=62) were male and 44.6% (n=50) were female. Mean age was recorded as 11.83+4.59. The mean pain scores at day zero post-operatively were calculated for both the groups and were compared through independent simple t test. The difference between groups was found statistically significant with p value of less than 0.001. Similarly, the mean pain scores at day first post-operatively were calculated for both the groups and were compared using an independent simple t test. The difference between both the groups was found statistically significant with a p value of less than 0.001. General mean pain score after tonsillectomy procedure was significantly lower in-group A, as compared to group B (5.11+1.08 Vs 6.76+1.18, p

 Conclusion

The intensity of throat pain in study participants who are considered for tonsillectomy procedure using cold dissection method might be reduced with the use of topical sucralfate, additionally with the other analgesic measures. This can increase the compliance levels of patients undergoing cold tonsillectomy procedure.

 Keywords tonsillectomy post-tonsillectomy pain sucralfate. References Asadpour N, Amani S, Malekpour Tehrani A, Azizian S. Frequency determination association of parent's smoking with tonsillectomy in children referring to Kashani hospital in Shahrekord in 2017-2018. Jundishapur Scient Med J. 2021;20(1):11-9. Niaz A, Saeed M, Hyder HS. Comparison of Bipolar Diathermy Tonsillectomy Versus Cold Steel Dissection Tonsillectomy. Ann Punjab Med Col. 2020;14(2):102-5. Ozler G, Cengiz A, Ertap A. Use of topical sucrulfate in the management of post operative pain after tonsillectomy. Ann Eu Med 2014; 2(3): 17-20 Ahmed AO, Aliyu I, Kolo E S. Indications for tonsillectomy and adenoidectomy: Our experience. Niger J Clin Pract 2014;17:90-4 Eriksson M, Nilsson U, Bramhagen AC, Idvall E, Ericsson E. Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy. Int J Pediatr Otorhinolaryngol. 2017;96:47-54. Aljfout Qais, Alississ A, Rashdan H, Maita A, Saraireh M. Antibiotics for Post-Tonsillectomy Morbidity: Comparative Analysis of a Single Institutional Experience. J Clin Med Res. 2016;8(5):385-388 Zagólskia Olaf, Mariusz Gajdab, Paweł Strek, Michael John Kozlowski, Artur Gadek, Jerzy Nyzioa. Adult tonsillectomy: postoperative pain depends on indications. Braz J Otorhinolaryngol. 2016;82(5):589-595 Brook I. Treatment Challenges of Group A Beta-hemolytic Streptococcal Pharyngo-Tonsillitis. Int. Arch. Otorhinolaryngol. 2017(03):286-96. Turner Logan. Diseases of the Nose, Throat and Ear: Head and Neck Surgery. Boca Raton. 11th Edition. CRC Press. 2016: 175-81 Klug TE, Rusan M, Fuursted K, Ovesen T. Peritonsillar abscess: complication of acute tonsillitis or Weber’s glands infection? Otolaryngol Head Neck Surg. 2016;155(2):199-207. Rokkjaer MS, Klug TE. Tonsillar malignancy in adult patients with peritonsillar abscess: retrospective study of 275 patients and review of the literature. Eur Arch Otorhinolaryngol. 2015;272(9):2439-44. Souza DL, Cabrera D, Gilani WI, Campbell RL, Carlson ML, Lohse CM, Bellolio MF. Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study. Laryngoscope. 2016;126(7):1529-34. Taskin U, Ozgur Y, Ayse S, Engin A. Efficacy of sucrulfate in the early postoperative improvement of Pediatric Thermal Welding adenotonsillectomy Morbidity. Turk Arch Otolaryngol 2013; 51(1): 15-9 Ozler G, Cengiz A, Ertap A. Use of topical sucrulfate in the management of post operative pain after tonsillectomy. Ann Eu Med 2014; 2(3): 17-20 Siupsinskiene Nora, Jurgita Žekonienė,Evaldas Padervinskis, Gediminas Žekonis, Saulius Vaitkus. Efficacy of sucralfate for the treatment of post-tonsillectomy symptoms. Eur Arch Otorhinolaryngol 2015; 272(2):271–278 Farmarzi M, Shishegar M, Heydari ST, Haghighi A, Sharouny H. Effects of Adenotonsillectomy on serum levels of IGF-1 and IGFBP-3 and growth indices in children with adenotonsillar hypertrophy or recurrent Tonsillitis. Iran J Otorhinolaryngol. 2016;28(88):329 Sinha P, Guragain RP, Bhusal CL, Sinha BK. Health Related Quality of Life in Children after Adeno-Tonsillectomy for Sleep Disordered Breathing. Pak J of Otolaryngol. 2013;29(1):90-2. Odhagen E, Sunnergren O, Hemlin C, Söderman AC, Ericsson E, Stalfors J. Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study. Eur Arch Otorhinolaryngol. 2019;273(10):3263-8. Gorman D, Ogston S, Hussain SS. Improvement in symptoms of obstructive sleep apnea in children following tonsillectomy versus tonsillotomy: a systematic review and meta analysis. Clin Otolaryngol. 2017;42(2):275-82.