Effect of Muscle Relaxant on Post-Tonsillectomy Pain

Jeon, Eun ju; Park, Yong Soo; Lee, Seok Eun; Park, Chan soon

Abstract

BACKGROUND AND OBJECTIVES
Pain is one of the most troublesome discomfort accompanying tonsillectomy. Pharyngeal muscle spasm is one of the causes of post-tonsillectomy pain. We investigated the effect of an oral central muscle relaxant agent (chlorophenesin carbamate: CPC) on post-tonsillectomy pain. MATERIALS AND METHOD: Thirty adult patients undergoing tonsillectomy were included in this study. Basic pain control per oral administration consisted of 3.0 g/day (t.i.d.) salicylsalicylic acid and intramuscular injection of 5 mg diclofenac sodium (DCF) on demand. The patient population was divided into CPC group (n=15) and control group (n=15) randomly. CPC Group (n=15) received additional oral ingestion of 375 mg (t.i.d.) CPC for 7 days after operation. Pain assesment was peformed using visual analogue scale (VAS) at rest and while swallowing at the first (POD1) and seventh (POD7) day of the operation. Pain relief score (PRS) is the difference between VAS at POD1 and POD7. The number of injection of DCF was compared also. RESULTS: VAS of CPC group and the control at POD1 were 1.9+/-1.7/4.8+/-2.3 (rest/swallowing) and 2.8+/-1.6/5.2+/-1.9, respectively. VAS of CPC group and the control at POD7 were 1.5+/-1.8/3.4+/-1.9 and 1.8+/-1.3/3.5+/-1.5, respectively. The VAS scores of the two groups at POD1 and POD7 are not significantly different. The PRS of CPC group and the control group were 1.7+/-0.7/1.4+/-1.4 (rest/swallowing) and 1.0+/-1.0/1.6+/-1.2 (rest/swallowing), respectively. No significant difference in PRS was observed between the two study groups. The number of injection of DCF between the two groups is not significantly different. CONCLUSION: No significant benefit is found for the use of oral muscle relaxant agent after tonsillectomy.