Efficacy of Sucralfate in alleviation of postoperative morbidity after tonsillectomy.

Abstract

Objectives: Despite of the therapeutic advancement, post-tonsillectomy pain is one of the most commonly observed morbidities associated with this surgical procedure which in turn highlights the need for appropriate analgesic consumption that assures safety and efficacy. Through this study our basic motive was to evaluate the sucralfate efficacy in the management of post-tonsillectomy symptoms during the first week of the surgery. Study Design: An Interventional, Quasi Experimental, (double-blind), purposive study. Setting: Department of Otorhinolaryngology and Head and Neck Surgery, Dow University of Health Sciences & Civil Hospital Karachi. Period: From January to June 2018. Material & Methods: One hundred and forty tonsillectomy patients of both genders between the age group of 7 to 35 years were randomly included in the study and categorized into 2 groups i.e. trial (Sucralfate group; Group A) and control (Pyodine group; Group B) with 70 patients in each group. The patients in group A were recommended to gargle with sucralfate suspension 4 times a day while following the same procedure except the group B interventional product was replaced with Pyodine mouth wash. The post-operative symptoms and secondary outcomes including pain, otalgia, odynophagia, analgesic requirements, slough shedding, bleeding and other associated side-effects were monitored. Pain, otalgia and odynophagia were assessed using the universal pain assessment tool (UPAT) while the secondary outcomes through a scoring system generated internally. Results: It is revealed from the study results that there was significant decrease in the throat pain and odynophagia in group A from 3^rd to 7^th post-tonsillectomy day (p < 0.05); while the results were not very significant for otalgia. The same could be applied for other secondary outcomes i.e. the analgesic requirement greatly decreased in patients given sucralfate presenting faster recovery. Moreover, early return to normal diet was observed for the patients treated with sucralfate. No serious adverse effects observed among the patients both groups. Conclusion: Sucralfate can be recommended as the first choice of treatment for the management of post-tonsillectomy symptoms on the basis of its efficiency in treating pain and other symptoms and hence providing maximum safety.