MULTIMODAL ANALGESIA FOR ADULT TONSILLECTOMY: SYSTEMATIC REVIEW AND CLINICAL ALGORITHM
Keywords:
Tonsillectomy, postoperative pain, multimodal analgesia, NSAIDs, lo-cal anesthetics, quality of rehabilitation, opioid-sparing effect.Abstract
The problem of adequately managing pain after tonsillectomy in adult patients re-mains unresolved, largely due to the risk of delayed complications such as dehy-dration and late postoperative hemorrhage. This review provides a critical analysis of current surgical and pharmacological strategies for pain management. Tradition-al opioid monotherapy is considered ineffective and unsafe. The implementation of multimodal analgesia (MMA) protocols incorporating nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, long-acting local anesthetics, and systemic glucocorticosteroids is therefore justified. Based on an analysis of relevant scientific literature published between 2021 and 2025, an optimized clinical man-agement algorithm was developed that may reduce overall opioid requirements by 35–40% and shorten the rehabilitation period [1,2].
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