OBJECTIVE: To explore the characteristics of post-operative pain following coblation tonsillectomy and/or adenoidectomy in children with sleep-disordered breathing (SDB) and explore the correlation between the first day post-operative pain scores and age and operating time. METHOD: 1) A total of 113 SDB children scheduled to undergo coblation tonsillectomy and/or adenoidectomy were recruited. 113 children were divided into two groups according to the method of operation, children who underwent coblation tonsillectomy and adenoidectomy were enrolled in study group one and children who underwent coblation adenoidectomy only were in study group two. Be sides, children of study group one with a history of chronic tonsillitis were in chronic tonsillitis group, children without a history of chronic tonsillitis were in non-chronic tonsillitis group. 2) The parents scored pain in their children on a VAS (anchored by "no pain" at 0 and "worst pain" at 10) in the morning, before using any analgesics and having breakfast, over the first 3 and the seventh post-operative days. 3) Post-operative pain scores were compared between both the study group one and two and chronic tonsillitis group and non-chronic tonsillitis group. Futhermore, the correlation between the first day post-operative pain scores and age and operating time were also analysed. RESULT: 1) The difference of post-operative pain scores over the first 3 and the seventh post-operative days were significant between the study group one and group two (P<0.05). 2) Non-chronic tonsillitis group were significantly less painful than chronic tonsillitis group on day 1, day 2 and day 7 (z=-2.004, -2.059, -2.334, P<0.05). But there was no significant difference in pain levels on day 3 (P>0.05). 3) The first day post-operative pain scores was correlated with age (r=0.273, P<0.01) and operating time (r=0.423, P<0.01). CONCLUSION The first day post-operative pain scores was correlated with age and operating time. Children with a history of chronic tonsillitis were more painful than children without the history.
Adenoidectomy ; adverse effects ; methods ; Child ; Child, Preschool ; Female ; Humans ; Hypothermia, Induced ; Male ; Pain Measurement ; Pain, Postoperative ; etiology ; Sleep Apnea Syndromes ; surgery ; Tonsillectomy ; adverse effects ; methods

OBJECTIVE： To systematically evaluate clinical efficacy and safety of Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray in the treatment of chronic rhinosinusitis， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from Embase， PubMed， the Cochrane library， CNKI， CBM， VIP and Wanfang database， RCTs about Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray （trial group） versus Triamcinolone acetonide nasal spray （control group） in the treatment of chronic rhinosinusitis were collected during database establishment to Dec. 8th， 2018. After data extraction and quality evaluation with Cochrane bias risk evaluation tool 5.1.0， Meta-analysis was performed for total response rate， nasal mucociliary transmission rate （MTR）， the levels of IL-5 and IL-8 in nasal secretion， SNOT-20 score， VAS score， Lund-Mackey nasal sinus CT score， the incidence of ADR （nausea， rash） by using Rev Man 5.3 software. TSA 0.9 software was used for trial sequential analysis（TSA）. RESULTS： A total of 9 RCTs were included， involving 998 patients. Results of Meta-analysis showed that total clinical response rate [RR＝1.20，95％CI（1.14，1.26），P＜0.001] of trial group was significantly higher than that of control group； MTR [MD＝－231.74，95％CI（－291.89，－171.58），P＜0.001]， IL-5 [MD＝－0.86，95％CI（－1.37， －0.35），P＜0.001] and IL-8 [MD＝－0.50，95％CI（－0.76， －0.25），P＜0.001] levels of trial group were significantly lower than those of control group. SNOT-20 score， VAS score and Lund-Mackey nasal sinus CT score of trial group were all lower than those of control group， with statistical significance （P＜0.001）. There was no statistical significance in the incidence of nausea [RR＝0.57，95％CI（0.17，1.92），P＝0.37] or rash [RR＝2.25，95％CI（0.70，7.20），P＝0.17] between 2 groups. TSA analysis showed that the evidence for therapeutic efficacy of Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray in the treatment of chronic rhinosinusitis was reliable. CONCLUSIONS： Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray is better than Triamcinolone acetonide nasal spray alone in improving total response rate of Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray in the treatment of chronic rhinosinusitis， reducing MTR， the levels of IL-5 and IL-8， and improving SNOT-20 score， VAS score and Lund-Mackey nasal sinus CT score， without increasing the incidence of nausea， rash.