Hostname: page-component-848d4c4894-mwx4w Total loading time: 0 Render date: 2024-07-05T01:55:30.651Z Has data issue: false hasContentIssue false

Secondary tonsillectomy haemorrhage and non-steroidal anti-inflammatory drugs

Published online by Cambridge University Press:  29 June 2007

I. Smith*
Affiliation:
From the Department of Otolaryngology, Huddersfield Royal Infirmary, Huddersfield, UK.
A. Wilde
Affiliation:
From the Department of Otolaryngology, Huddersfield Royal Infirmary, Huddersfield, UK.
*
Address for correspondence: Mr Ian Smith, ENT Specialist Registrar, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ.

Abstract

Modern non-steroidal anti-inflammatory drugs (NSAIDs), are now widely accepted analgesics for posttonsillectomy patients, but their effect on secondary haemorrhage has not been fully evaluated.

This study attempts to evalute the influence of NSAIDs on the secondary haemorrhage rate, and also whether mode of dissection is an important factor.

The records of 557 consecutive patients undergoing tonsillectomy were studied to determine if there was a relationship between the secondary haemorrhage rate and discharge prescription of NSAIDs.

There was an overall secondary haemorrhage rate of 5.2 per cent (29) and a significantly increased secondary haemorrhage rate in those taking regular NSAIDs, 11 per cent, compared to those not taking NSAIDs, 1.47 per cent, ().

There was a higher rate of secondary haemorrhages with bipolar dissection than with standard dissection for both those taking and not taking NSAIDs (13 per cent vs seven per cent and 2.75 per cent vs 0.87 per cent) however this was not statistically significant ( and ). Both bipolar dissection and standard dissection individually showed very significant increases in secondary haemorrhage rate when on regular NSAIDs ( and ).

Although NSAIDs are very good analgesics, they may cause an increased secondary haemorrhage rate, and should be prescribed at discharge prescription with caution.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carmody, D., Vamadevan, T., Cooper, S. M. (1982) Posttonsillectomy haemorrhage. Journal of Laryngology and Otology 96: 635638.CrossRefGoogle Scholar
Cronberg, S., Wallmark, E., Soderberg, I. (1984) Effect on platelet aggregation of oral administration of 10 nonsteroidal analgesics to humans. Scandanavian Journal of Haematology 33: 155159.CrossRefGoogle ScholarPubMed
Dommerby, H., Dasmussen, O. R. (1984) Diclofenac, pain relieving effect after tonsillectomy. Acta Otolaryngologica (Stockh) 98: 185192.CrossRefGoogle ScholarPubMed
Haberman, R. S., Shattuck, T. G., Dion, N. M. (1990) Is outpatient suction cautery tonsillectomy safe in a community hospital setting. Laryngoscope 100: 511515.CrossRefGoogle Scholar
Koch-Weser, J. (1980) Nonsteroidal anti-inflammatory drugs. New England Journal of Medicine 302: 11791185.CrossRefGoogle Scholar
Kotecha, B., O'Leary, G., Bradburn, J., Darowski, M., Gwinnutt, C. L. (1991) Pain relief after tonsillectomy in adults: intramuscular diclofenac and papavertum compared. Clinical Otolaryngology 16: 345349.CrossRefGoogle ScholarPubMed
Lee, W. C., Sharp, J. F. (1996) Complications of paediatric tonsillectomy post-discharge. Journal of Laryngology and Otology 110(2): 136140.CrossRefGoogle ScholarPubMed
Maniglia, A. J., Kushner, H., Cozzi, L. (1989) Adenotonsillectomy: a safe outpatient procedure. Archives of Otolaryngology-Head and Neck Surgery 115: 9294.CrossRefGoogle ScholarPubMed
Murthy, P., Laing, M. R. (1998) Dissection tonsillectomy: pattern of post-operative pain, medication and resumption of normal activity. Journal of Laryngology and Otology 112: 4144.CrossRefGoogle ScholarPubMed
Power, I., Chambers, W. A., Greer, I. A., Ramage, D., Simon, E. (1990) Platelet function after intramuscular diclofenac. Anaesthesia 45: 916919.CrossRefGoogle ScholarPubMed
Reiner, S. A., Sawyer, W. P., Clark, K. F., Wood, M. W. (1990) Safety of outpatient tonsillectomy and adenoidectomy. Otolaryngology-Head and Neck Surgery 102: 161168.CrossRefGoogle ScholarPubMed
Reuter, S. H., Montgomery, W. W. (1984) Aspirin vs acetaminophen after tonsillectomy. Archives of Otolaryngology 80: 214217.Google Scholar
Robinson, P. M., Ahmed, I. (1994) Diclofenac and posttonsillectomy haemorrhage. Clinical Otolaryngology 19: 344345.CrossRefGoogle Scholar
Shott, S. R., Myer, C. M., Cotton, R. T. (1987) Efficacy of tonsillectomy and adenoidectomy as an outpatient procedure: a preliminary report. International Journal of Paediatric Otolaryngology 13: 157163.CrossRefGoogle ScholarPubMed
Stage, J., Jensen, J. H., Bonding, P. (1988)Post-tonsillectomy haemorrhage and analgesics. A comparative study of acetylsalcylic acid and paracetamol. Clinical Otolaryngology 13: 201204.CrossRefGoogle Scholar