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. 2025 Mar 20;17(3):e80905.
doi: 10.7759/cureus.80905. eCollection 2025 Mar.

Bleeding and Pain Post-tonsillectomy: An Adult Cohort Study

Elliot Heward  1 , John Rocke  1 , George McNally  1 , Sian Dobbs  2 , Safdar Sarwar  3 , Sara Timms  4 , Sadie Khwaja  3 , Nirmal Kumar  1
Affiliations

Bleeding and Pain Post-tonsillectomy: An Adult Cohort Study

Elliot Heward et al. Cureus. .

Abstract

Background Tonsillectomy is one of the most common surgical procedures performed. This study aimed to understand the rate and severity of post-operative bleeding and pain in adult patients undergoing tonsillectomy in the United Kingdom. Methods A total of 10 secondary and tertiary otolaryngology units recruited adults prior to tonsillectomy and provided them with a diary to complete and return. This diary recorded the frequency and severity of post-operative bleeding and the intensity and pattern of post-operative pain. Results In total, 75 patients were recruited with 18 complete patient diaries analysed (median age 24.8, range: 17-50 years); of these 12 (67%) reported post-operative bleeding. Pain was most severe on Days 4-6 (median score 8/10) and then declined over the 21-day study period. There were 21 post-operative interactions with healthcare services recorded by these patients: 15 emergency department and six general practice visits. Conclusion This study demonstrates the pattern of post-procedural pain and bleeding in adult tonsillectomy and the high rate of interaction with healthcare providers. Improved understanding will allow more accurate consent conversations and patient counselling.

Keywords: peri-operative analgesia; post-operative bleeding; post-operative care; post-operative pain; tonsillectomy.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. West of Scotland REC 1 issued approval 20/WS/0013. This study received full ethical approval by the West of Scotland Research Ethics Service on the 22nd January 2020 and the Health Research Authority on the 27th January 2020 (20/WS/0013). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This study received funding through two open competitive funding applications through the ENT UK Foundation and BVM Medical. The funders had no role in design or delivery of this study. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Post-tonsillectomy diary
Note: This image was created by the authors for this study.
Figure 2
Figure 2. Bleeding following tonsillectomy by post-operative day
Figure 3
Figure 3. Median post-operative pain against return to work following tonsillectomy by post-operative day
Figure 4
Figure 4. Interaction with healthcare services following tonsillectomy by post-operative day
See this image and copyright information in PMC

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