Evidence map›Paper›PMID 40321015›Full record

Trial reportAnaesthesia2025

Impact of honey on post-tonsillectomy pain in children (BEE PAIN FREE Trial): a multicentre, double-blind, randomised controlled trial.

David Sommerfield, Aine Sommerfield, Daisy Evans, Neil Hauser, Shyan Vijayasekaran, Paul Bumbak, Hayley Herbert, Cornelia Locher, Lee Yong Lim, R Nazim Khan and 1 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

David SommerfieldDepartment of Anaesthesia and Pain Medicine, Perth Children's Hospital, Nedlands, WA, Australia.ORCID 0000-0003-3600-1315
Aine SommerfieldPeri-operative Medicine Team, Peri-operative Care Program, Telethon Kids Institute, Nedlands, WA, Australia.ORCID 0000-0001-8418-5572
Daisy EvansInstitute for Paediatric Peri-operative Excellence, The University of Western Australia, Perth, WA, Australia.ORCID 0000-0001-8262-5706
Neil HauserDepartment of Anaesthesia and Pain Medicine, Perth Children's Hospital, Nedlands, WA, Australia.ORCID 0000-0002-8868-0690
Shyan VijayasekaranInstitute for Paediatric Peri-operative Excellence, The University of Western Australia, Perth, WA, Australia.ORCID 0000-0001-7990-6742
Paul BumbakInstitute for Paediatric Peri-operative Excellence, The University of Western Australia, Perth, WA, Australia.
Hayley HerbertInstitute for Paediatric Peri-operative Excellence, The University of Western Australia, Perth, WA, Australia.ORCID 0000-0002-0287-6175
Cornelia LocherInstitute for Paediatric Peri-operative Excellence, The University of Western Australia, Perth, WA, Australia.ORCID 0000-0001-8773-3036
Lee Yong LimInstitute for Paediatric Peri-operative Excellence, The University of Western Australia, Perth, WA, Australia.ORCID 0000-0002-7307-0742
R Nazim KhanInstitute for Paediatric Peri-operative Excellence, The University of Western Australia, Perth, WA, Australia.ORCID 0000-0003-3349-5006
Britta S von Ungern-SternbergDepartment of Anaesthesia and Pain Medicine, Perth Children's Hospital, Nedlands, WA, Australia.ORCID 0000-0002-8043-8541

Funding

National Health and Medical Research Council 2009322Stan Perron Charitable FoundationWestern Australian Health Translation Project
6 · The paper itself

Abstract

introductionTonsillectomy, a common childhood surgery, is associated with difficult postoperative recovery. Previous reviews provided low-grade evidence that honey may improve recovery. The BEE PAIN FREE study investigated whether honey alongside multimodal analgesia improved the recovery trajectory in children following tonsillectomy.

methodsA prospective randomised controlled trial was conducted across three centres in Western Australia. Children undergoing extracapsular tonsillectomy by coblation were allocated randomly to one of four postoperative treatment groups: standard treatment alone; Marri honey (from Western Australia); Manuka honey (from Western Australia); or placebo. The intervention groups took 5 ml of honey or placebo, six times a day, for at least 7 days, in addition to usual discharge analgesia (standard treatment). Data for daily pain scores, Parents' Postoperative Pain Measure scores, medications and unplanned re-presentations were collected.

resultsA total of 400 children were recruited; 20% were lost to follow-up or withdrew. The mean number of honey doses taken varied between 2 and 3 doses per day over 7 days. Treatment with honey at this frequency did not impact postoperative pain scores significantly, with all groups showing similar trajectories. These findings did not alter with as-treated analysis or using imputed models for missing data. Most children experienced significant pain until around postoperative day 8. Children allocated to the honey and placebo groups showed some improved oral tolerance around day 6 but had increased vomiting during earlier days. There were no clinically significant differences in medical re-presentations, simple analgesia or oxycodone usage between groups. DISCUSSION: Two to three doses daily of oral honey/placebo in children post-extracapsular tonsillectomy for 7 days, in addition to regular paracetamol, ibuprofen and as required oxycodone did not result in a clinical improvement in pain or recovery over a 14-day follow-up period.

Indexed as

HoneyPostoperative PainTonsillectomyChildChild, PreschoolDouble-Blind MethodFemaleHumansMalePain MeasurementProspective Studiesanaesthesiaoutcomepaediatricpaintonsillectomy

Identifiers

PMID40321015
PMCPMC12256161

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.