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Abstract The main concern after tonsillectomy is post-operative pain, it is a very important and unpleasant feature of tonsillectomy and one of the most obstacles we found postoperative. The reason of pain after tonsillectomy is mechanical or thermal damage of surrounding tissue that results in inflammation, spasm of the exposed pharyngeal muscles and nerve irritation. It has been proposed that the choice of tonsillectomy technique, to prescribe sufficient pain medication and given proper counseling for pain management after discharge to allow a smooth recovery may have significant implications for postoperative pain. So, we can divide the measures for reducing postoperative pain according to the tool used in the surgery, the technique during surgery, systemic medications and non-pharmacological treatment. There are several techniques for tonsillectomy and their relative effectiveness remains a matter of debate. Each has its advantages and disadvantages and the method chosen by the surgeon has often depended on their personal preference based on training and experience. There are different techniques can we used to decrease post operative pain we can do it during surgery. One of these techniques is tonsillar fossa closure by sutures; sealing was performed by laying the posterior pillar mucosa over the tonsillar fossa and suturing it with anterior pillar mucosa. Another technique during tonsillectomy is application of local anesthesia either by preincisional peritonsillar infiltration, posttonsillectomy wound infiltration and post-tonsillectomy packing with soaked gauze. Also topical application of magnesium sulfate and sucralfate was beneficial in reduction of pain in the postoperative period but cannot be utilized as a single agent for pain relief in children. It is simple, safe, tolerated, and low-cost; it is an important tool as adjuvant treatment of post-tonsillectomy pain. Advances in new surgical techniques make this surgery a safe procedure with less pain however, postoperative morbidity and in particular the treatment of postoperative pain continues to be a controversial point, with no clear consensus on its ideal treatment. The search for various treatments to decrease postoperative morbidity in tonsillectomy is justifiable. Many therapeutic modalities ranging from analgesics, corticosteroids and antibiotics have been used as effective means for post tonsillectomy pain control in children. While medical drugs are being used for treating the somatic (physiological and emotional) dimension of the pain, nonpharmacological therapies aim to treat also the affective, cognitive, behavioral and socio-cultural dimensions of the pain. These non pharmacologic techniques, such as honey which decreases the need to analgesics via pain reduction after surgery, cold diet which increased the pain threshold and reduce the edema and treat the pain by taking the inflammation process under control and at the same time allow the patient to get fluids in, transcutaneous electrical nerve stimulation which help reducing the pain level and dosage of using analgesics by artificial stimulation of nerve fibers which try to stop or reduce the pain transmission, relaxing therapy and distraction which increases the tolerance for pain and decrease the sensitivity for pain by getting the attention away from the pain and also acupuncture can be used in an attempt to alleviate postoperative pain. |