Postoperative pain management after uvulopharyngopalatoplasty is a common clinical problem. This well-designed study from Iran describes the novel use of vitamin C as an analgesic. The precise mechanism of action is not clearly defined, but appears to be related to its antioxidant properties. It is an attractive proposition because it does not cause respiratory depression nor postoperative bleeding, which are the side-effects of opiates and NSAIDS, respectively. This study assessed 40 patients in a randomised double-blinded controlled trial. The treatment group received 3g of vitamin C in 500ml Ringer’s solution, and the control group 6ml of normal saline in the same volume of Ringer’s solution. Visual analogue pain scores were significantly better in the treatment group. Additionally, the treatment group required significantly less supplemental analgesia in the form of paracetamol and pethidine than the control group. The main drawback of the study is that it only assessed patients up to 24 hours postoperatively. Assessing the effect on postoperative pain over a two-week period would be far more interesting.

Effect of intravenous vitamin C on postoperative pain in uvulopalatopharyngoplasty with tonsillectomy.
Ayatollah V, Dehghanpour FS, Behdad S, et al.
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Serge Latis

Liverpool Hospital, Sydney, NSW, Australia.

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