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Efficacy of clindamycin in reducing pain following tonsillectomy in adults: a double-blind, randomised trial

Published online by Cambridge University Press:  04 November 2013

M H Baradaranfar ,
V Zand ,
M H Dadgarnia  and
S Atighechi
M H Baradaranfar*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Shahid Sadoughi Hospital, Yazd, Iran Rhinology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
V Zand
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Shahid Sadoughi Hospital, Yazd, Iran
M H Dadgarnia
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Shahid Sadoughi Hospital, Yazd, Iran
S Atighechi
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Shahid Sadoughi Hospital, Yazd, Iran
*
Address for correspondence: Professor Mohammd Hossein Baradaranfar, Department of Otolaryngology, Head and Neck Surgery, Shahid Sadoughi Hospital, Avicenna Blvd, Safaeeh, Yazd, Iran Fax: +98 3518224100 E-mail: baradaranf@yahoo.com
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Abstract

Objective:

Tonsillectomy is a common operation performed in children and young adults. Pain and post-operation haemorrhage are its most common complications. This study was designed to evaluate the efficacy of topical antibiotics in reducing throat pain after tonsillectomy in adult patients.

Methods:

A double-blind, placebo-controlled, randomised clinical trial was conducted, enrolling 30 patients older than 18 years who were scheduled to undergo tonsillectomy. Patients were randomly assigned to receive either clindamycin or normal saline (as placebo). Throat pain severity was evaluated using a visual analogue scale.

Results:

All patients in both groups had experienced a reduction in pain by the seventh day after surgery. There was no statistically significant difference in the extent of visual analogue scale pain score reduction, comparing the placebo and clindamycin groups throughout the study course (p = 0.424).

Conclusion:

Topical clindamycin was not demonstrated to be more effective than normal saline in the reduction of throat pain following tonsillectomy in adults.

Keywords

TonsillectomyPainAntibioticsClindamycinAdministration, Topical
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 11 , November 2013 , pp. 1106 - 1110
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Blair, RL, McKerrow, WS, Carter, NW, Fenton, A. The Scottish tonsillectomy audit. Audit Sub-Committee of the Scottish Otolaryngological Society. J Laryngol Otol 1996;110(suppl 20):1–25CrossRefGoogle ScholarPubMed
2Handler, SD, Miller, L, Richmond, KH, Baranak, CC. Post-tonsillectomy hemorrhage: incidence, prevention and management. Laryngoscope 1986;96:1243–7CrossRefGoogle ScholarPubMed
3Lee, WC, Sharp, JF. Complications of paediatric tonsillectomy post-discharge. J Laryngol Otol 1996;110:136–40CrossRefGoogle ScholarPubMed
4Valtonen, H, Qvarnberg, Y, Blomgren, K. Patient contact with healthcare professionals after elective tonsillectomy. Acta Otolaryngol 2004;124:1086–9CrossRefGoogle ScholarPubMed
5Fredelius, L, Olin, AO, Grenrot, C, Axelsson, G, Hemlin, C. Ambulatory tonsillectomy stimulates the development of postoperative pain therapy [in Swedish]. Lakartidningen 1999;96:3666Google ScholarPubMed
6Sutters, KA, Miaskowski, C. Inadequate pain management and associated morbidity in children at home after tonsillectomy. J Pediatr Nurs 1997;12:178–85CrossRefGoogle ScholarPubMed
7Warnock, FF, Lander, J. Pain progression, intensity and outcomes following tonsillectomy. Pain 1998;75:37–45CrossRefGoogle ScholarPubMed
8Robinson, SR, Purdie, GL. Reducing post-tonsillectomy pain with cryoanalgesia: a randomized controlled trial. Laryngoscope 2000;110:1128–31CrossRefGoogle ScholarPubMed
9Ernst, E, Fialka, V. Ice freezes pain? A review of the clinical effectiveness of analgesic cold therapy. J Pain Symptom Manage 1994;9:56–9CrossRefGoogle Scholar
10Johansen, M, Harbo, G, Illum, P. Preincisional infiltration with bupivacaine in tonsillectomy. Arch Otolaryngol Head Neck Surg 1996;122:261–3CrossRefGoogle ScholarPubMed
11Moir, MS, Bair, E, Shinnick, P, Messner, A. Acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy. Laryngoscope 2000;110:1824–7CrossRefGoogle ScholarPubMed
12April, MM, Callan, ND, Nowak, DM, Hausdorff, MA. The effect of intravenous dexamethasone in pediatric adenotonsillectomy. Arch Otolaryngol Head Neck Surg 1996;122:117–20CrossRefGoogle ScholarPubMed
13Carr, MM, Williams, JG, Carmichael, L, Nasser, JG. Effect of steroids on posttonsillectomy pain in adults. Arch Otolaryngol Head Neck Surg 1999;125:1361–4CrossRefGoogle ScholarPubMed
14Ohlms, LA, Wilder, RT, Weston, B. Use of intraoperative corticosteroids in pediatric tonsillectomy. Arch Otolaryngol Head Neck Surg 1995;121:737–42CrossRefGoogle ScholarPubMed
15Dhiwakar, M, Eng, CY, Selvaraj, S, McKerrow, WS. Antibiotics to improve recovery following tonsillectomy: a systematic review. Otolaryngol Head Neck Surg 2006;134:357–64CrossRefGoogle ScholarPubMed
16Mann, EA, Blair, EA, Levy, AJ, Chang, A. Effect of topical antibiotic therapy on recovery after tonsillectomy in adults. Otolaryngol Head Neck Surg 1999;121:277–82CrossRefGoogle Scholar
17Aslam, M, Mustafa, G. Prophylactic antibiotics for tonsillectomy: experience at Rawalpindi General Hospital. J Coll Physicians Surg Pak 1998;8:36–8Google Scholar
18Jurkiewicz, D, Wojdas, A, Rapiejko, P, Kantor, I, Hermanowski, M, Usowski, J et al. Application of fusafungine in perioperative period in patients after tonsillectomy [in Polish]. Pol Merkur Lekarski 2004;16:358–61Google ScholarPubMed
19O'Reilly, BJ, Black, S, Fernandes, J, Panesar, J. Is the routine use of antibiotics justified in adult tonsillectomy? J Laryngol Otol 2003;117:382–5CrossRefGoogle ScholarPubMed
20Colreavy, MP, Nanan, D, Benamer, M, Donnelly, M, Blaney, AW, O'Dwyer, TP et al. Antibiotic prophylaxis post-tonsillectomy: is it of benefit? Int J Pediatr Otorhinolaryngol 1999;50:15–22CrossRefGoogle ScholarPubMed
21Zagólski, O, Kulisiewicz, J. Perioperative antibiotic in adenoidectomy with partial tonsillectomy: a randomized trial. ORL J Otorhinolaryngol Relat Spec 2012;74:86–92CrossRefGoogle ScholarPubMed
22Miura, MS, Saleh, C, de Andrade, M, Assmann, M, Lima, LH, Lubianca Neto, JF. Topical clindamycin in post-adenotonsillectomy analgesia in children: a double-blind, randomized clinical trial. Otolaryngol Head Neck Surg 2009;141:509–15CrossRefGoogle ScholarPubMed
23Lukan, N. Fusafungine after tonsillectomy [in German]. Laryngorhinootologie 2002;81:426–9CrossRefGoogle ScholarPubMed
24Cohen, J. Statistical Power Analysis for the Social Sciences. Hillsdale, New Jersey: Erlbaum, 1988Google Scholar
25Swanson, D, Maxwell, RA, Johnson, JT, Wagner, RL, Yu, VL. Cefonicid versus clindamycin prophylaxis for head and neck surgery in a randomized, double-blind trial, with pharmacokinetic implications. Antimicrob Agents Chemother 1991;35:1360–4CrossRefGoogle Scholar
26Orrling, A, Stjernquist-Desatnik, A, Schalen, C. Clindamycin in recurrent group A streptococcal pharyngotonsillitis – an alternative to tonsillectomy? Acta Otolaryngol 1997;117:618–22CrossRefGoogle Scholar
27Jensen, JH, Larsen, SB. Treatment of recurrent acute tonsillitis with clindamycin. An alternative to tonsillectomy? Clin Otolaryngol Allied Sci 1991;16:498–500CrossRefGoogle ScholarPubMed
28Brook, I. The role of β-lactamase-producing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect Dis 1984;6:601–7CrossRefGoogle ScholarPubMed
29Jebeles, JA, Reilly, JS, Gutierrez, JF, Bradley, EL Jr, Kissin, I. Tonsillectomy and adenoidectomy pain reduction by local bupivacaine infiltration in children. Int J Pediatr Otorhinolaryngol 1993;25:149–54CrossRefGoogle ScholarPubMed
30Boliston, TA, Upton, JJM. Infiltration with lignocaine and adrenaline in adult tonsillectomy. J Laryngol Otol 1980;94:1257–9CrossRefGoogle ScholarPubMed
31Giannoni, C, White, S, Enneking, FK, Morey, T. Ropivacaine with or without clonidine improves pediatric tonsillectomy pain. Arch Otolaryngol Head Neck Surg 2001;127:1265–70CrossRefGoogle ScholarPubMed
32Jebeles, JA, Reilly, JS, Gutierrez, JF, Bradley, EL Jr, Kissin, I. The effect of pre-incisional infiltration of tonsils with bupivacaine on the pain following tonsillectomy under general anesthesia. Pain 1991;47:305–8CrossRefGoogle ScholarPubMed
33Molliex, S, Haond, P, Baylot, D, Prades, JM, Navez, M, Elkhoury, Z et al. Effect of pre- vs postoperative tonsillar infiltration with local anesthetics on postoperative pain after tonsillectomy. Acta Anaesthesiol Scand 1996;40:1210–15CrossRefGoogle ScholarPubMed
34Ørntoft, S, Løngreen, A, Møiniche, S, Dhal, JB. A comparison of pre- and postoperative tonsillar infiltration with bupivacaine on pain after tonsillectomy. A pre-emptive effect? Anaesthesia 1994;49:151–4CrossRefGoogle ScholarPubMed
35Ohlms, LA. Injection of local anesthetic in tonsillectomy. Arch Otolaryngol Head Neck Surg 2001;127:1276–8CrossRefGoogle ScholarPubMed
36Steward, DL, Welge, JA, Myer, CM. Do steroids reduce morbidity of tonsillectomy? Meta-analysis of randomized trials. Laryngoscope 2001;111:1712–18CrossRefGoogle ScholarPubMed
37Catlin, FI, Grimes, WJ. The effect of steroid therapy on recovery from tonsillectomy in children. Arch Otolaryngol Head Neck Surg 1991;117:649–52CrossRefGoogle Scholar
38Volk, MS, Martin, P, Brodsky, L, Stanievich, JF, Ballou, M. The effects of preoperative steroids on tonsillectomy patients. Otolaryngol Head Neck Surg 1993;109:726–30CrossRefGoogle ScholarPubMed
39Ohlms, LA, Wilder, RT, Weston, B. Use of intraoperative corticosteroids in pediatric tonsillectomy. Arch Otolaryngol Head Neck Surg 1995;121:737–42CrossRefGoogle ScholarPubMed
40Vosdoganis, F, Baines, DB. The effect of single dose intravenous dexamethasone in tonsillectomy in children. Anaesth Intensive Care 1999;27:489–92CrossRefGoogle ScholarPubMed
41Papangelou, L. Steroid therapy in tonsillectomy. Laryngoscope 1972;82:297–302CrossRefGoogle ScholarPubMed
42Telian, SA, Handler, SD, Fleisher, GR, Baranak, CC, Wetmore, RF, Potsic, WP. The effect of antibiotic therapy on recovery after tonsillectomy in children. A controlled study. Arch Otolaryngol Head Neck Surg 1986;112:610–15CrossRefGoogle Scholar
43Luderitz, O, Tanamoto, K, Galanos, C, McKenzie, GR, Brade, H, Zahringer, U et al. Lipopolysaccharides: structural principles and biologic activities. Rev Infect Dis 1984;6:428–31CrossRefGoogle ScholarPubMed
44Luderitz, T, Brandenburg, K, Seydel, U, Roth, A, Galanos, C, Rietschel, ET. Structural and physicochemical requirements of endotoxins for the activation of arachidonic acid metabolism in mouse peritoneal macrophages in vitro. Eur J Biochem 1989;179:11–16CrossRefGoogle ScholarPubMed
45Bhakdi, S, Klonisch, T, Nuber, P, Fischer, W. Stimulation of monokine production by lipoteichoic acids. Infect Immun 1991;59:4614–20CrossRefGoogle ScholarPubMed
46Card, GL, Jasuja, RR, Gustafson, GL. Activation of arachidonic acid metabolism in mouse macrophages by bacterial amphiphiles. J Leukoc Biol 1994;56:723–8CrossRefGoogle ScholarPubMed
47Chacur, M, Milligan, ED, Gazda, LS, Armstrong, C, Wang, H, Tracey, KJ et al. A new model of sciatic inflammatory neuritis (SIN): induction of unilateral and bilateral mechanical allodynia following acute unilateral peri-sciatic immune activation in rats. Pain 2001;94:231–44CrossRefGoogle ScholarPubMed
48Eliav, E, Herzberg, U, Ruda, MA, Bennett, GJ. Neuropathic pain from an experimental neuritis of the rat sciatic nerve. Pain 1999;83:169–82CrossRefGoogle ScholarPubMed