Abstract
Objective: To define the analgesic regimen given following tonsillectomy in a large otolaryngology center and correlate this with readmission for secondary complications.
Method: Case notes for patients undergoing tonsillectomy were collected between February and August 2011. Information was collated and entered into a database including age, gender, operation type, indication, medications on discharge, and details of readmission. Data were assessed for correlations, particularly that between readmission and analgesic regimen given following tonsillectomy.
Results: One hundred twenty-five patients underwent tonsillectomy during the six-month period (mean age of 13.8 years, range 3 months to 65 years). The most common indication for surgery was recurrent tonsillitis and with most carried out by bipolar dissection. A total of 64.8% of patients were discharged as day cases. Seventeen different postoperative analgesic regimens were identified with the most common being acetaminophen and ibuprofen in combination (26.4%). Of the patients, 20.0% had no documented analgesia on discharge. Thirteen patients (10.4%) were readmitted following discharge from hospital postoperatively, 4 (3.2%) for issues related to pain. There was no correlation between analgesic regimens and readmission, including those without formal analgesic prescriptions.
Conclusion: No apparent link between readmission and analgesic regimen was identified. The lack of opioid analgesics does not appear to affect readmission rates. However the vast variation of analgesic regimens and lack of formal instructions for those advised over-the-counter analgesics has prompted development of a formal step-based protocol.
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