Table 4.

Recommended pain management in patients undergoing tonsillectomy^a.

Preoperative and intraoperative	Gradeb
Paracetamol	D
Non-steroidal anti-inflammatory drugs	A
Dexamethasone intravenously	A
Preoperative gabapentinoids, or intraoperative ketamine (for children), or intraoperative dexmedetomidine may be considered, when basic analgesic regimen is contraindicated	D
Analgesic adjuncts
Acupuncture	B
Postoperative
Paracetamol	D
Non-steroidal anti-inflammatory drugs	A
Opioid for rescue	D
Analgesic adjuncts
Acupuncture	B
Honey	B

A, consistent level 1 studies; B, consistent level 2 or 3 studies or extrapolations from level 1 studies; C, level 4 studies or extrapolations from level 2 or 3 studies; D, level 5 evidence or troubling inconsistent or inconclusive studies of any level.

^a In accordance with Aldamluji et al. (62) and Guyatt (107).

^b Grades (https://www.gradeworkinggroup.org/).