- Design
- Systematic review and meta-analysis of 13 comparative studies
- Population
- Patients undergoing tonsillectomy given perioperative intraoral sucralfate vs placebo or none
- Primary outcome
- Postoperative pain and analgesic use
- Effect
- Less throat, swallowing and ear pain and analgesic use; faster diet resumption; no increase in bleeding
Post-tonsillectomy pain is a major source of poor oral intake, dehydration and readmission, and non-opioid options are welcome. This meta-analysis pooled 13 studies comparing perioperative intraoral sucralfate with placebo or no treatment.
Sucralfate was associated with less throat pain, swallowing pain and referred ear pain, lower analgesic use, better mucosal healing at five to seven days, and faster return to a normal diet. Importantly, it did not increase postoperative bleeding or nausea and vomiting.
For a common operation where pain control is often inadequate, this supports intraoral sucralfate as a cheap, low-risk adjunct worth considering within a multimodal, opioid-sparing regimen. The trials vary in preparation and dosing, so it complements rather than replaces standard analgesia, and local protocols should define how it is given.
- Sucralfate was associated with less throat pain, swallowing pain and otalgia, and lower analgesic use.
- It improved mucosal healing at 5–7 days and sped return to a normal diet.
- Postoperative bleeding and nausea/vomiting were not increased.
- Consider intraoral sucralfate as a low-cost adjunct within a multimodal, opioid-sparing analgesic plan.
Why it matters
It adds a non-opioid, inexpensive option to a procedure where pain control is frequently inadequate.
Don't overread it
Trials differed in sucralfate preparation and dosing, so this supports it as an adjunct, not a standardised protocol or a replacement for standard analgesia.
The statistics, in plain English
The review reports consistent direction of benefit across pain and recovery measures rather than a single pooled number; the reassuring part is that bleeding — the main tonsillectomy risk — was not raised.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for ent & head and neck surgery, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free