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Complex evaluation of pain after tonsillectomy
Abstract:Conclusion. Postoperative odynophagia should be assessed by a variety of methods including visual analogue scale (VAS) pain scores (subjective), clinical data (objective qualitative) and surface electromyography (sEMG; objective quantitative). sEMG might be used for quantitative evaluation of odynophagia when aggravation or hysteria-conversion reaction is suspected. Tonsillectomy affects muscle activity significantly by involving additional muscles in deglutition. Objectives. Complex evaluation of post tonsillectomy odynophagia was used for objective assessment of complaints of operated patients. Patients and methods. Parameters evaluated for 50 randomly chosen operated adults included VAS pain score, clinical data, and the EMG data such as the timing, electric amplitude and graphic patterns of muscular activity during deglutition. We investigated masseter (MS), infrahyoid (INF) and submental-submandibular (SUB) muscles. The results were compared with a normative database. The patients were first tested 12 h after surgery and were monitored for 30 days. The sEMG data were compared with VAS pain score with regard to changes in clinical condition of the patients. Results. Signs of clinical recovery after tonsillectomy did not always correspond with the VAS pain score evolution. sEMG was more in concord with clinical recovery than VAS. Electric activity of MS and LSM was significantly higher among the patients in comparison with a normative database (p<0.005).
Keywords:Tonsillectomy  postoperative pain  surface electromyography
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