Efficacy of honey in reduction of post tonsillectomy pain, randomized clinical trial

https://doi.org/10.1016/j.ijporl.2014.08.018Get rights and content

Abstract

Objectives

Tonsillectomy is one of the most common operations performed in pediatric population. One of the most prevalent tonsillectomy complications is early or delayed post-operative hemorrhage. Other important morbidity is post-operative pain. Historically, honey has been used for wound control, reducing the inflammation, and healing acceleration. The aim of this study is to investigate the effect of honey on reducing pain after tonsillectomy in children 5–15 years old.

Methods

After tonsillectomy, 80 patients were randomly divided in two equal groups. Patients in the first group were treated with antibiotic and acetaminophen, while those in the second group were treated with antibiotic, acetaminophen and honey. Data was gathered via a questionnaire and observation of tonsillar bed healing. Data was analyzed by SPSS17 software and related tests.

Results

Pain comparison between two groups showed that the average time required for pain relief in patients who received honey was less than the control. The pain intensity was higher during the first 9 days post-operatively in control group. Results also showed that acetaminophen consumption in patients who received honey is lower. In the case group, the average time to resume regular diet and the frequency of awakening at night is significantly less than the control group.

Conclusion

Honey administration after tonsillectomy has valuable effect in pain relief and it can be used as an adjunctive regimen after surgery for better pain control.

Introduction

The human tonsils are immunologically active tissue during childhood. Infectious and inflammatory diseases involving the pharynx, tonsils, and adenoids often result in two of the most common surgical procedures in children: tonsillectomy and adenoidectomy [1]. Tonsillectomy is among the most common surgical procedures performed worldwide. Although simple and usually associated with low complication rate, this surgical procedure can occasionally lead to dangerous complications. Generally current indications of tonsillectomy are infection, upper airway obstruction, suspected neoplasia, and asymmetric tonsillar hypertrophy [2]. Following surgery, complications such as pain, hemorrhage, velopharyngeal insufficiency (VPI), cervical spine complications, airway obstruction and pulmonary edema, nasopharyngeal stenosis, foreign body aspiration, low fever, and otalgia may develop, management of which is provided by different methods [2]. One of the most common morbidities is pain.

Historically, biologic activity and therapeutic effects of honey have received attention from clinicians [3]. Nevertheless, antibacterial and anti-inflammatory effects of honey are shown in recent studies. Experimental and clinical studies indicate that honey prevents wound infection and leads to decreased inflammation, rapid healing, and epithelialization of wound site [4]. Some authors believe extra-capsular muscle exposure would lead to pain. Therefore, if re-epithelialization occurs as soon as possible, the pain will decrease faster [1]. The aim of this study is to investigate the effect of oral honey administration on reducing pain subsequent to tonsillectomy surgery in a population of 5–15 year old patients selected by surgeon.

Section snippets

Methods and materials

The study is a randomized clinical trial, which is accepted by research committee of faculty of medicine and Institutional Review Board (IRB) in Hormozgan University of Medical Science (HUMS). Ethical committee accepted the project by ethic code HEC-90-5-3. We evaluated 80 patients undergoing tonsillectomy at Shahid Mohammadi hospital (Bandar Abbas city) between March 2011 and March 2012. The patients were included according to criteria such as tonsillectomy indication (surgeon decision),

Statistical analysis

Data obtained by using questionnaire and physical examination of patients was recorded. Statistical analysis was performed using SPSS software (version 17.0 for windows). Descriptive statistics was used to determine frequency and description of data. T-test was used to compare quantitative data such as age difference between two groups, and Chi-square test was used to compare qualitative data such as gender difference between two groups. Mann–Whitney statistical test was used to compare

Discussion

Many studies have been conducted to investigate the role of honey in accelerating the wound healing process and reducing the infection rate of wounds of various etiologies; however, there are few data available on the role of honey in pain reduction. Pain management is a vital element of any surgery.

In a retrospective study performed by Gupta et al., it was demonstrated that honey has a significant effect in reducing infection rate and accelerating healing on burn wound [5]. Subrahmanyam

Conclusion

According to our results from pain intensity measurements and acetaminophen consumption, honey can effectively reduce pain. Also, returning to regular oral intake can be faster. Although awakening at night caused by severe pain has been positively influenced by administration of oral honey, the difference was not shown to be statistically significant. More detailed controlled interventional studies with larger sample size are required to draw a more reliable conclusion.

Acknowledgments

This article is the result of a medical student thesis and we would like to thank all the members of the research committee of faculty of medicine and Institutional Review Board (IRB) in Hormozgan University of Medical Science (HUMS). We are grateful to all the subjects and parents who participated in the study.

References (16)

There are more references available in the full text version of this article.

Cited by (0)

View full text