The role of postoperative sucralfate in adults following tonsillectomy and sleep surgery: a systematic review

Abstract

Purpose: To investigate the efficacy of topical sucralfate on postoperative recovery following oropharyngeal surgery in adults using pain scales, analgesic use, and various self-reported measures. Methods: CINAHL, Cochrane Library, PubMed, and SCOPUS databases were searched from inception through July 3, 2024. Randomized controlled trials related to topical sucralfate following oropharyngeal surgery in patients at least 18 years old were included. Study protocols for clinical trials, abstracts, and non-English language articles were excluded. Two authors extracted data, and disagreements were resolved with a third party if needed. Risk of bias was assessed according to Risk of Bias 2 (RoB 2) tool. Results of included studies and a narrative summary of our findings are presented through descriptive statistics (frequency (%) for categorical variables and mean (range) for continuous variables). Results: Four studies (n = 185) pertaining to topical sucralfate and post-operative outcomes in an adult population were included. The sucralfate group had a mean age of 40.08 vs. 37.50 for the control group. The sucralfate group had a significantly higher reduction in pain scores than the control group. The sucralfate group also had statistically significant improvements in otalgia, strength, diet tolerance, and reduction in analgesic use compared to the control group in two of the four studies. Conclusions: Oropharyngeal surgery is commonly performed in adults despite having a morbid recovery process. The literature shows promising results with the use of sucralfate in the reduction of post-operative pain in adults; however, further investigation is warranted given the limited scope of the literature.