AB082. 225. A comparative audit of post-tonsillectomy pain management

Background: Post-operative pain is common and a relatively common reason for post-operative patients attending Emergency Department (ED) and hospital readmission. Inadequate pain relief is an ongoing problem particularly in adults after tonsillectomy. It is associated with poor feeding, dehydration, delayed healing and increased risk of haemorrhage. Despite many publications comparing postoperative pain management, there is a lack of standardised post tonsillectomy analgesia prescription. This has to lead to an individual based prescription contrary to evidence-based prescription. The aim of the current study was to compare the readmission rate for pain in adult post tonsillectomy patients between a combination of diclofenac and paracetamol at discharge as against a cocktail of paracetamol, Arcoxia and Oxynorm.

Methods: A retrospective comparative audit of adult post tonsillectomy patients was performed on patients treated by a single surgeon at Barringtons Hosspital Limerick (BHL) for a period of 2 years spanning from September 2015 to September 2017.

Results: The first group from September 2015 to September 2016 representing the era when the combination of diclofenac and paracetamol was used as a discharge analgesia while September 2016 to September 2017 representing the period when the combination of Oxynorm, Arcoxia and paracetamol was used as a discharging analgesia.

Conclusions: There were no hospital readmissions for pain management in the second group as compared to the first one.

Keywords: Tonsillectomy; pain; analgesia; audit