Nasal Sprays Containing Mometasone Furoate for Relief of Post-Adenotonsillectomy Pain in Children: A Prospective Controlled Study

Abstract

Objectives: Adenotonsillectomy is one of most common surgeries performed in childhood. Post-operative pain associated particularly with tonsillectomy is still a problem for many physicians. Despite advances in surgical techniques, analgesics, or anti-inflammatory drugs, no unique strategy for post-tonsillectomy pain management has been suggested. The aim of this study is to investigate the analgesic effect of steroid containing nasal spray applied to tonsillar region after tonsillectomy.

Methods: Eighty-two patients were assigned into two groups as study and control. In study group, nasal spray containing steroid was applied to each tonsillar region after surgery for 5 days. Post-operative pain of all patients was assessed using a visual analog scale and results were compared.

Results: Pain decreased gradually over time in both the study and control groups. Although the pain scores from 4 h post-surgery to post-operative day 5 were not found to significantly decrease in children that used nasal spray containing steroid, these patients developed less pain on post-operative day 5,with statistical significance (p<0.05).

Conclusion: Post-tonsillectomy pain was reported to increase around post-operative day 5, which coincides with the time of intense wound inflammation. Therefore, significant pain reduction on post-operative day 5 observed in children that used nasal spray with steroid may have clinical importance for overcoming this problem.

Keywords: Mometasone furoate; nasal spray; pain relief; steroid; tonsillectomy; visual analogue scale.

Figure 1

Wong Baker® FACES scale used to assess the post-operative pain of children.

Figure 2

Demonstration of the mean pain scores in the study and control groups based on the post-operative time. The post-operative day 5 scores were statistically significant between the groups. Patients that used steroid spray had less pain on post-operative day 5 than patients that were only given paracetamol. P score: Pain score; *Statistical significance (p=0.033).