الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
The main concern after tonsillectomy is post-operative pain, it is a very
important and unpleasant feature of tonsillectomy and one of the most
obstacles we found postoperative. The reason of pain after tonsillectomy
is mechanical or thermal damage of surrounding tissue that results in
inflammation, spasm of the exposed pharyngeal muscles and nerve
irritation. It has been proposed that the choice of tonsillectomy technique,
to prescribe sufficient pain medication and given proper counseling for
pain management after discharge to allow a smooth recovery may have
significant implications for postoperative pain.
So, we can divide the measures for reducing postoperative pain
according to the tool used in the surgery, the technique during surgery,
systemic medications and non-pharmacological treatment.
There are several techniques for tonsillectomy and their relative
effectiveness remains a matter of debate. Each has its advantages and
disadvantages and the method chosen by the surgeon has often depended
on their personal preference based on training and experience.
There are different techniques can we used to decrease post operative
pain we can do it during surgery. One of these techniques is tonsillar
fossa closure by sutures; sealing was performed by laying the posterior
pillar mucosa over the tonsillar fossa and suturing it with anterior pillar
mucosa.
Another technique during tonsillectomy is application of local
anesthesia either by preincisional peritonsillar infiltration, posttonsillectomy
wound infiltration and post-tonsillectomy packing with
soaked gauze.
Also topical application of magnesium sulfate and sucralfate was
beneficial in reduction of pain in the postoperative period but cannot be
utilized as a single agent for pain relief in children. It is simple, safe,
tolerated, and low-cost; it is an important tool as adjuvant treatment of
post-tonsillectomy pain.
Advances in new surgical techniques make this surgery a safe
procedure with less pain however, postoperative morbidity and in
particular the treatment of postoperative pain continues to be a
controversial point, with no clear consensus on its ideal treatment. The
search for various treatments to decrease postoperative morbidity in
tonsillectomy is justifiable. Many therapeutic modalities ranging from
analgesics, corticosteroids and antibiotics have been used as effective
means for post tonsillectomy pain control in children.
While medical drugs are being used for treating the somatic
(physiological and emotional) dimension of the pain, nonpharmacological
therapies aim to treat also the affective, cognitive,
behavioral and socio-cultural dimensions of the pain. These non
pharmacologic techniques, such as honey which decreases the need to
analgesics via pain reduction after surgery, cold diet which increased the
pain threshold and reduce the edema and treat the pain by taking the
inflammation process under control and at the same time allow the patient
to get fluids in, transcutaneous electrical nerve stimulation which help
reducing the pain level and dosage of using analgesics by artificial
stimulation of nerve fibers which try to stop or reduce the pain
transmission, relaxing therapy and distraction which increases the
tolerance for pain and decrease the sensitivity for pain by getting the
attention away from the pain and also acupuncture can be used in an
attempt to alleviate postoperative pain.