Research status of analgesia management in children undergoing tonsillectomy

Tonsillectomy is one of the most common surgical procedures performed in children, and postoperative pain significantly impacts their recovery. Coblation and intracapsular tonsillotomy are emerging as superior techniques for tonsillectomy, offering advantages such as reducing postoperative pain, fewer complications, and faster recovery. A systematic review based on a large number of clinical studies has confirmed that regular oral administration of ibuprofen and acetaminophen, along with intraoperative dexamethasone, are safe and effective for the treatment of postoperative pain after tonsillectomy. The use of opioids during tonsillectomy in children is effective for immediate postoperative analgesia, but due to its potential risk of respiratory depression, its routine use in children is not recommended. Additionally, alternative therapies such as cold therapy, honey and acupuncture as non-drug components of multimodal analgesia can relieve pain in children after tonsillectomy. Dexmedetomidine and ketamine during tonsillectomy has a certain effect in reducing acute agitation, opioid requirements and auxiliary analgesia in children undergoing tonsillectomy. However, there are still few research data so far, and the research quality is low. Large-sample, multicenter randomized clinical trials are needed for further research and confirmation. Ultrasound-guided glossopharyngeal nerve block (GNB) is effective in treating pain in children after tonsillectomy and is expected to become a new strategy for postoperative analgesia in children after tonsillectomy. The author intends to explain the latest research status of the surgical methods of tonsillectomy and mechanisms of postoperative pain in children after tonsillectomy, as well as the treatment strategies for pain in children after tonsillectomy, aiming to provide guidance for the clinical treatment of pain in such children. © 2024 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.