Pain and postoperative hemorrhage after tonsillectomy

Kaisa Tolska

Research output: ThesisDoctoral Thesis


Studies have shown that acute postoperative pain is still undertreated in many common surgical procedures such as tonsillectomy, as pain may go unnoticed in everyday practice. Recovery after tonsillectomy may be complicated also by post-tonsillectomy hemorrhage (PTH), which can even be life threatening. The aim of this study was to investigate immediate complications after tonsillectomy particularly pain and PTH, and to evaluate the evidence regarding the analgesic effect of systemic analgesics and dexamethasone for post-tonsillectomy pain and whether topical ropivacaine is effective in the prevention of pain. Studies I and II are retrospective chart reviews including 1533 outpatients operated for tonsillectomy over one year in our institution, that analyzed the incidence of PTH in adult patients (Study I) and the incidence of all postoperative complications of pediatric patients (Study II), and their association with perioperatively administered medications. Study III is a systematic review and meta-analysis on analgesics and dexamethasone for the prevention or treatment of post-tonsillectomy pain in adults and adolescents including 29 randomized, double-blind, placebo-controlled studies. Study IV is a prospective double-blind placebo-controlled study on topical ropivacaine applied to tonsillar beds after removal of tonsils for the prevention of post-tonsillectomy pain in 154 adult patients.
Original languageEnglish
  • Takala, Annika, Supervisor
  • Kontinen, Vesa, Supervisor
Place of PublicationHelsinki
Print ISBNs978-951-51-5490-3
Electronic ISBNs978-951-51-5491-0
Publication statusPublished - 2019
MoE publication typeG5 Doctoral dissertation (article)

Bibliographical note

M1 - 69 s. + liitteet

Fields of Science

  • Tonsillectomy
  • Postoperative Complications
  • Pain, Postoperative
  • Pain Management
  • Postoperative Hemorrhage
  • Perioperative Care
  • Acetaminophen
  • Adult
  • Analgesics
  • Anti-Inflammatory Agents
  • Child
  • Codeine
  • Cortisone
  • Dexamethasone
  • Dextromethorphan
  • Drug Combinations
  • Epinephrine
  • Gabapentin
  • Lidocaine
  • Oxycodone
  • Pregabalin
  • Reoperation
  • Ropivacaine
  • Treatment Outcome
  • 3126 Surgery, anesthesiology, intensive care, radiology

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