Characterization of pain in the first two weeks after tonsillectomy in children 3 to 8 years old. A pilot study.

Abstract

Introduction and objective: To study the pain in children is a challenge. Tonsillectomy is a very common and painful surgical procedure in which there are still barriers to warrant an adequate pain management. The purpose of this study is to characterize the pain after surgery in children between 3 and 8 years-old who underwent tonsillectomy.
 Method: We performed a descriptive, observational and prospective study in children aged 3 to 8 who underwent tonsillectomy. The data collection was made through a pain questionnaire based in the intensity of pain from 0-10 in the Wong Baker scale (based on drawn faces). Parents also fulfilled other questions about the days that the children could not attend the school and the working days that the parents themselves lost. The analgesic treatment that each child received was also recorded.
 Results: Twenty-nine patient were included, 14 girls and 15 boys with a median age of 4. The highest level of pain was found the second day with a median value of 3,0. This second day was so chosen to compare the level of pain between indications. The median pain was 3,0 when it was for obstructive disease, but 4,0 when obstruction was associated with facial growth disorders. Children lost a median of 8 days at school and their parents 2 days at work each one.
 Discussion: Our limited data suggest that the long-term side effects of the upper airway obstruction due to tonsillar hypertrophy like disorders of facial growth made the surgery more painful and that the pain had in our environment a greater impact in patients and their parents lifes. It appears to be important to stablish a scheduled analgesic treatment for the first 10 days after surgery.