PERIOPERATIVE ANESTHESIA DURING SURGICAL INTERVENTIONS ON THE LYMPHOEPITHELIAL PHARYNGEAL RING IN CHILDREN
Review
Published September 4, 2023
Keywords
pharyngeal ring
children
pain management
children
pain management
How to Cite
Agafonov V. N., Yakushenkova A. P., Pasechnick I. N., Timashkov D. A., Bershina A. N. PERIOPERATIVE ANESTHESIA DURING SURGICAL INTERVENTIONS ON THE LYMPHOEPITHELIAL PHARYNGEAL RING IN CHILDREN // Kremlin Medicine Journal. 2023. VOL. № 3. С. 85-91.
Abstract
Surgeries on the lymphoepithelial pharyngeal ring are one of the most common surgical interventions in pediatric ENT practice. At the same time, postoperative pain is an inherent complication after this type of interventions, and it can often be a long-lasting process. Despite a large number of available non-narcotic analgesics, which are often used in combination with various pharmpreparations, achieving an adequate level of pain control is an unsolved problem yet. In addition, there are still questions on safety and efficacy of the most commonly used analgesic drugs, which are prescribed in different curative regimens, what leads to controversial results. The purpose of this review is to summarize current scientific literature on pharmacotherapy regimens applied in children surviving surgeries on the lymphoepithelial pharyngeal ring, so as to find curative algorithms which are able to maximally control postoperative pain and are able to minimize a potential harm to the patient with respect to his/her individual features.References
1. Agafonov V.N. et al. Improvement of the anesthetic support in adenotonsillectomy in children // Kremlin Medicine Journal. – 2022. – № 4. – P. 65–69. In Russian.
2. Jensen D.R. Pharmacologic management of post-tonsillectomy pain in children // World J Otorhinolaryngol Neck Surg. – 2021. – V. 7. – № 03. – P. 186–193.
3. Mitchell R.B. et al. Clinical practice guideline: tonsillectomy in children (update) // World J Otorhinolaryngol Neck Surg. – 2019. – V. 160. – P. S1–S42.
4. Aldamluji N. et al. PROSPECT guideline for tonsillectomy: systematic review and procedure‐specific postoperative pain management recommendations // Anaesthesia. – 2021. – V. 76. – № 7. – P. 947–961.
5. Vlasova G.V. et al. Postoperative pain syndrome in pediatric otorhinolaryngology // Folia ORL et PR. – 2021. – V. 27. – № 1. – P. 61–71. In Russian.
6. Moir M.S. et al. Acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy // Laryngoscope. – 2000. – V. 110. – № 11. – P. 1824–1827.
7. Kohler J.E. et al. Continued prescribing of periprocedural codeine and tramadol to children after a black box warning // J Surg Res. – 2020. – V. 256. – P. 131–135.
8. Smith H.S. Opioid metabolism // Mayo Clinic Proceedings. – Elsevier, 2009. – V. 84. – № 7. – P. 613–624.
9. Savva N.N. Morphine in children's palliative care // Onkopediatria. – 2015. – V. 2. – № 1. – P. 39–46. In Russian]\.
10. Oremule B. et al. Oral morphine for pain management in paediatric patients after tonsillectomy and adenotonsillectomy // Int J Pediatr Otorhinolaryngol. – 2015. – V. 79. – № 12. – P. 2166–2169.
11. Persino P.R. et al. Pain control following tonsillectomy in children: a survey of patients // Int J Pediatr Otorhinolaryngol. – 2017. – V. 103. – P. 76–79.
12. Kireev S.S. Methods of postoperative analgesia in children // Topical clinical studies in the new conditions of the COVID-19 pandemic. – 2020. – P. 20–24. In Russian.
13. Klimov L.Ya. et al. Fulminant liver failure with acetaminophen. Literature review and demonstration of a clinical case // Medical Council. – 2018. – № 11. – P. 76–83. In Russian.
14. Chisholm A.G. et al. Does intravenous acetaminophen reduce perioperative opioid use in pediatric tonsillectomy? // Am J Otolaryngol. – 2019. – V. 40. – № 6. – P. 102–294.
15. Ulrich G.E. et al. Postoperative anesthesia in children. What standards should we use? // Regional anesthesia and treatment of acute pain. – 2015. – V. 9. – № 2. – P. 40–45. In Russian.
16. Mudd P.A. et al. Association between ibuprofen use and severity of surgically managed posttonsillectomy hemorrhage // JAMA Otolaryngol Head Neck Surg. – 2017. – V. 143. – № 7. – P. 712–717.
17. Diercks G.R. et al. Comparison of ibuprofen vs acetaminophen and severe bleeding risk after pediatric tonsillectomy: a noninferiority randomized clinical trial // JAMA Otolaryngol Head Neck Surg. – 2019. – V. 145. – № 6. – P. 494–500.
18. Pickering A.E. et al. Double‐blind, placebo‐controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children // Br J Anaesth. – 2002. – V. 88. – № 1. – P. 72–77.
19. Abuzarova G.R. Pain relief for adults and children in the provision of medical care: guidelines. – Moscow: Ministry of Health of the Russian Federation, Pirogov Russian National Research Medical University, Association of Professional Members of Hospice Care. – 2016. In Russian.
20. Ushkalova E.A. et al. Sodium metamizole: regulatory status around the world, safety problems and medication errors // Safety and Risk of Pharmacotherapy. – 2022. – V. 10. – № 4. – P. 396–410. In Russian.
21. Tolska H.K. et al. Topical ropivacaine in prevention of post-tonsillectomy pain in adults // Anesth Analg. – 2017. – V. 124. – № 5. – P. 1459–1466.
22. Junaid M. et al. Intraoperative use of analgesics in tonsillar fossa and postoperative evaluation with visual analogue scale scores-a prospective, randomized, placebo-controlled, double-blind clinical trial // Int Arch Otorhinolaryngol. – 2020. – V. 24. – P. e62–e67.
23. Bean-Lijewski J.D. Glossopharyngeal nerve block for pain relief after pediatric tonsillectomy: retrospective analysis and two cases of life-threatening upper airway obstruction from an interrupted trial // Anesth Analg. – 1997. – V. 84. – № 6. – P. 1232–1238.
24. Park H.P. et al. The effects of glossopharyngeal nerve block on postoperative pain relief after tonsillectomy: the importance of the extent of obtunded gag reflex as a clinical indicator // Anesth Analg. – 2007. – V. 105. – № 1. – P. 267–271.
25. Debasish G. et al. Glossopharyngeal nerve block with long acting local anaesthetic agent (bupivacaine) and it’s effect on early post-operative period in adult tonsillectomy: a prospective study // Indian J Otolaryngol Head Neck Surg. – 2019. – V. 71. – P. 390–394.
26. Steward D.L. et al. Steroids for improving recovery following tonsillectomy in children // Cochrane Database Syst Rev. – 2011. – № 8.
27. Redmann A.J. et al. The effect of postoperative steroids on post‐tonsillectomy pain and need for postoperative physician contact // Laryngoscope. – 2018. – V. 128. – № 9. – P. 2187–2192.
28. Sharma K. et al. Effect of single-dose dexmedetomidine on intraoperative hemodynamics and postoperative recovery during pediatric adenotonsillectomy // Anesthes Essays Res. – 2019. – V. 13. – № 1. – P. 63.
29. Mathiesen O. et al. Pregabalin and dexamethasone improves post‐operative pain treatment after tonsillectomy // Acta Anaesthesiol Scand. – 2011. – V. 55. – № 3. – P. 297–305.
30. Gettis M. et al. Gabapentin premedication to reduce postoperative pain for pediatric tonsillectomy/adenoidectomy: a pilot study // J PeriAnesth Nurs. – 2022. – V. 37. – № 5. – P. 626–631.
31. Javid M.J. et al. Evaluation of a low dose ketamine in post tonsillectomy pain relief: a randomized trial comparing intravenous and subcutaneous ketamine in pediatrics // Anesthesiol Pain Med. – 2012. – V. 2. – № 2. – P. 85.
32. Lal A. et al. Role of honey after tonsillectomy: a systematic review and meta‐analysis of randomised controlled trials // Clin Otolaryngol. – 2017. – V. 42. – № 3. – P. 651–660.
33. Cho H.K. et al. Can perioperative acupuncture reduce the pain and vomiting experienced after tonsillectomy? A meta‐analysis // Laryngoscope. – 2016. – V. 126. – № 3. – P. 608–615.
34. Albeladi M.A. et al. The Effect of ice cream intake on pain relief for patients after tonsillectomy // Cureus. – 2020. – V. 12. – № 7.
2. Jensen D.R. Pharmacologic management of post-tonsillectomy pain in children // World J Otorhinolaryngol Neck Surg. – 2021. – V. 7. – № 03. – P. 186–193.
3. Mitchell R.B. et al. Clinical practice guideline: tonsillectomy in children (update) // World J Otorhinolaryngol Neck Surg. – 2019. – V. 160. – P. S1–S42.
4. Aldamluji N. et al. PROSPECT guideline for tonsillectomy: systematic review and procedure‐specific postoperative pain management recommendations // Anaesthesia. – 2021. – V. 76. – № 7. – P. 947–961.
5. Vlasova G.V. et al. Postoperative pain syndrome in pediatric otorhinolaryngology // Folia ORL et PR. – 2021. – V. 27. – № 1. – P. 61–71. In Russian.
6. Moir M.S. et al. Acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy // Laryngoscope. – 2000. – V. 110. – № 11. – P. 1824–1827.
7. Kohler J.E. et al. Continued prescribing of periprocedural codeine and tramadol to children after a black box warning // J Surg Res. – 2020. – V. 256. – P. 131–135.
8. Smith H.S. Opioid metabolism // Mayo Clinic Proceedings. – Elsevier, 2009. – V. 84. – № 7. – P. 613–624.
9. Savva N.N. Morphine in children's palliative care // Onkopediatria. – 2015. – V. 2. – № 1. – P. 39–46. In Russian]\.
10. Oremule B. et al. Oral morphine for pain management in paediatric patients after tonsillectomy and adenotonsillectomy // Int J Pediatr Otorhinolaryngol. – 2015. – V. 79. – № 12. – P. 2166–2169.
11. Persino P.R. et al. Pain control following tonsillectomy in children: a survey of patients // Int J Pediatr Otorhinolaryngol. – 2017. – V. 103. – P. 76–79.
12. Kireev S.S. Methods of postoperative analgesia in children // Topical clinical studies in the new conditions of the COVID-19 pandemic. – 2020. – P. 20–24. In Russian.
13. Klimov L.Ya. et al. Fulminant liver failure with acetaminophen. Literature review and demonstration of a clinical case // Medical Council. – 2018. – № 11. – P. 76–83. In Russian.
14. Chisholm A.G. et al. Does intravenous acetaminophen reduce perioperative opioid use in pediatric tonsillectomy? // Am J Otolaryngol. – 2019. – V. 40. – № 6. – P. 102–294.
15. Ulrich G.E. et al. Postoperative anesthesia in children. What standards should we use? // Regional anesthesia and treatment of acute pain. – 2015. – V. 9. – № 2. – P. 40–45. In Russian.
16. Mudd P.A. et al. Association between ibuprofen use and severity of surgically managed posttonsillectomy hemorrhage // JAMA Otolaryngol Head Neck Surg. – 2017. – V. 143. – № 7. – P. 712–717.
17. Diercks G.R. et al. Comparison of ibuprofen vs acetaminophen and severe bleeding risk after pediatric tonsillectomy: a noninferiority randomized clinical trial // JAMA Otolaryngol Head Neck Surg. – 2019. – V. 145. – № 6. – P. 494–500.
18. Pickering A.E. et al. Double‐blind, placebo‐controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children // Br J Anaesth. – 2002. – V. 88. – № 1. – P. 72–77.
19. Abuzarova G.R. Pain relief for adults and children in the provision of medical care: guidelines. – Moscow: Ministry of Health of the Russian Federation, Pirogov Russian National Research Medical University, Association of Professional Members of Hospice Care. – 2016. In Russian.
20. Ushkalova E.A. et al. Sodium metamizole: regulatory status around the world, safety problems and medication errors // Safety and Risk of Pharmacotherapy. – 2022. – V. 10. – № 4. – P. 396–410. In Russian.
21. Tolska H.K. et al. Topical ropivacaine in prevention of post-tonsillectomy pain in adults // Anesth Analg. – 2017. – V. 124. – № 5. – P. 1459–1466.
22. Junaid M. et al. Intraoperative use of analgesics in tonsillar fossa and postoperative evaluation with visual analogue scale scores-a prospective, randomized, placebo-controlled, double-blind clinical trial // Int Arch Otorhinolaryngol. – 2020. – V. 24. – P. e62–e67.
23. Bean-Lijewski J.D. Glossopharyngeal nerve block for pain relief after pediatric tonsillectomy: retrospective analysis and two cases of life-threatening upper airway obstruction from an interrupted trial // Anesth Analg. – 1997. – V. 84. – № 6. – P. 1232–1238.
24. Park H.P. et al. The effects of glossopharyngeal nerve block on postoperative pain relief after tonsillectomy: the importance of the extent of obtunded gag reflex as a clinical indicator // Anesth Analg. – 2007. – V. 105. – № 1. – P. 267–271.
25. Debasish G. et al. Glossopharyngeal nerve block with long acting local anaesthetic agent (bupivacaine) and it’s effect on early post-operative period in adult tonsillectomy: a prospective study // Indian J Otolaryngol Head Neck Surg. – 2019. – V. 71. – P. 390–394.
26. Steward D.L. et al. Steroids for improving recovery following tonsillectomy in children // Cochrane Database Syst Rev. – 2011. – № 8.
27. Redmann A.J. et al. The effect of postoperative steroids on post‐tonsillectomy pain and need for postoperative physician contact // Laryngoscope. – 2018. – V. 128. – № 9. – P. 2187–2192.
28. Sharma K. et al. Effect of single-dose dexmedetomidine on intraoperative hemodynamics and postoperative recovery during pediatric adenotonsillectomy // Anesthes Essays Res. – 2019. – V. 13. – № 1. – P. 63.
29. Mathiesen O. et al. Pregabalin and dexamethasone improves post‐operative pain treatment after tonsillectomy // Acta Anaesthesiol Scand. – 2011. – V. 55. – № 3. – P. 297–305.
30. Gettis M. et al. Gabapentin premedication to reduce postoperative pain for pediatric tonsillectomy/adenoidectomy: a pilot study // J PeriAnesth Nurs. – 2022. – V. 37. – № 5. – P. 626–631.
31. Javid M.J. et al. Evaluation of a low dose ketamine in post tonsillectomy pain relief: a randomized trial comparing intravenous and subcutaneous ketamine in pediatrics // Anesthesiol Pain Med. – 2012. – V. 2. – № 2. – P. 85.
32. Lal A. et al. Role of honey after tonsillectomy: a systematic review and meta‐analysis of randomised controlled trials // Clin Otolaryngol. – 2017. – V. 42. – № 3. – P. 651–660.
33. Cho H.K. et al. Can perioperative acupuncture reduce the pain and vomiting experienced after tonsillectomy? A meta‐analysis // Laryngoscope. – 2016. – V. 126. – № 3. – P. 608–615.
34. Albeladi M.A. et al. The Effect of ice cream intake on pain relief for patients after tonsillectomy // Cureus. – 2020. – V. 12. – № 7.