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Sucralfate, Clindamycin Rinse Ease Kids' Pain after Tonsillectomy


June 25, 2014

By Reuters Staff

NEW YORK - Both sucralfate and clindamycin rinse significantly reduce pain following tonsillectomy, with no important side effects, according to a randomized controlled trial conducted in Iran.

Topical sucralfate and clindamycin "efficiently reduce sore throat after tonsillectomy and help children return to normal life sooner," say Dr. Jalal Poorolajal from Hamadan University of Medical Sciences in Hamadan, Iran and colleagues.

Their study, released online June 19 in JAMA Otolaryngology Head and Neck Surgery, included 101 children six to 12 years old undergoing tonsillectomy.

The oral cavity was washed before and immediately after surgery with 10 mL of either sucralfate, clindamycin, or placebo solution for one minute and then suctioned. Eight hours after surgery, the patients were asked to keep 10 mL of the prepared mouthwash solution in their mouths for one minute three times a day for three days. Sore throat was evaluated daily for five days using the Faces Pain Scale-Revised (zero=no pain and 10=the most severe pain).

On post-surgery days one through four, average throat pain scores were significantly higher in the placebo group than in both active rinse groups.

Scores on day one were 8.00 for placebo vs 6.00 for sucralfate and 6.79 for clindamycin (p=0.001). Pain scores were not significantly different on day five.

Acetaminophen use was more common on days three and four in the placebo group than the sucralfate group and the clindamycin group (p=0.001 and p=0.02, respectively).

On the first postop day, bleeding was more common with placebo (3 of 34, vs none in the two drug groups), and intolerance to food was less common with sucralfate (2 of 34) than placebo (9 of 34) or clindamycin (11 of 33) (p=0.02).

Sucralfate and clindamycin were well tolerated with no important side effects, the authors say.

Dr. Poorolajal and colleagues conclude that both agents are effective for postop pain after tonsillectomy. They note that because the two drugs have different mechanisms, "sucralfate and clindamycin may reduce postoperative pain synergistically if used in combination with each other. However, this issue must be investigated in future investigations."

The study was funded by the Vice Chancellor of Research and Technology, Hamadan University of Medical Sciences. The authors have no disclosures. They did not respond to request for comment by press time.

SOURCE: bit.ly/UFpCno

JAMA Otolaryngol Head Neck Surg 2014.

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