Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2024, Vol. 20 ›› Issue (06): 707 -714. doi: 10.3877/cma.j.issn.1673-5250.2024.06.016

Forum

Research status of analgesia management in children undergoing tonsillectomy

Fengting Ma1,2, Yunxia Zuo1,3, Jian Zou4, Fei Liu1,3,()   

  1. 1. Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China
    2. Department of Anesthesiology,The First People's Hospital of Shuangliu District,West China (Airport)Hospital,Sichuan University,Chengdu 610200,Sichuan Province,China
    3. The Research Units of West China(2018RU 012),Chinese Academy of Medical Sciences,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China
    4. Department of Otolaryngology,Head and Neck Surgery,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China
  • Received:2024-06-21 Revised:2024-11-13 Published:2024-12-01
  • Corresponding author: Fei Liu

Tonsillectomy is one of the most common surgical procedures performed in children,and postoperative pain significantly impacts their recovery.Coblation and intracapsular tonsillotomy are emerging as superior techniques for tonsillectomy,offering advantages such as reducing postoperative pain,fewer complications,and faster recovery.A systematic review based on a large number of clinical studies has confirmed that regular oral administration of ibuprofen and acetaminophen,along with intraoperative dexamethasone,are safe and effective for the treatment of postoperative pain after tonsillectomy.The use of opioids during tonsillectomy in children is effective for immediate postoperative analgesia,but due to its potential risk of respiratory depression,its routine use in children is not recommended.Additionally,alternative therapies such as cold therapy,honey and acupuncture as non-drug components of multimodal analgesia can relieve pain in children after tonsillectomy.Dexmedetomidine and ketamine during tonsillectomy has a certain effect in reducing acute agitation,opioid requirements and auxiliary analgesia in children undergoing tonsillectomy.However,there are still few research data so far,and the research quality is low.Large-sample,multicenter randomized clinical trials are needed for further research and confirmation.Ultrasound-guided glossopharyngeal nerve block(GNB)is effective in treating pain in children after tonsillectomy and is expected to become a new strategy for postoperative analgesia in children after tonsillectomy.The author intends to explain the latest research status of the surgical methods of tonsillectomy and mechanisms of postoperative pain in children after tonsillectomy,as well as the treatment strategies for pain in children after tonsillectomy,aiming to provide guidance for the clinical treatment of pain in such children.

图1 扁桃体的神经支配示意图
图2 扁桃体切除术患儿术中镇痛的针灸穴位示意图(图2A:合谷穴;图2B:内关穴与神门穴;图2C:照海穴;图2D:扣带回穴、大脑主穴与扁桃体穴)
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