Ketoprofen and fentanyl for pain after uvulopalatopharyngoplasty and tonsillectomy

Objectives: The treatment of postoperative pain after uvulopalatopharyngopl asty (UPPP) and tonsillectomy presents a challenge. Opioids can cause sedat ion and respiratory depression. Nonsteroidal anti-inflammatory drugs can in crease postoperative bleeding. The authors have evaluated the severity of p ostoperative pain and the consumption of opioid in 53 adult patients underg oing either UPPP or tonsillectomy, Study Design: A prospective, parallel-gr oups study, Methods: A general endotracheal anesthesia was used in each pat ient. After surgery patients received ketoprofen 1 mg/kg as an intravenous bolus, followed by a continuous infusion of 4 mg/kg during 24 hours. For re scue analgesia patient-controlled intravenous fentanyl was used. Results: B oth UPPP and tonsillectomy are associated with intense postoperative pain. More than 40% of the patients had high pain scores during the first 24 post operative hours. Postoperative pain after UPPP was more severe and the diff erence was significant during swallowing (P < .05). The need for fentanyl i n the UPPP group was twice that of the tonsillectomy group (P < .01). There was a high interindividual scatter in the patient-controlled fentanyl atte mpts in both groups. The patients in the UPPP group needed significantly mo re oxygen supply during recovery (P = .007). No serious adverse effects occ urred and none of the patients experienced postoperative bleeding that requ ired any intervention. Conclusion: Individually tailored analgesic treatmen t protocol is essential for patients undergoing UPPP and tonsillectomy to e nsure safe and effective pain alleviation.