Abstract
IntroductionAlthough culturally food and physical activity restriction are part of the routine postoperative care of many Brazilian surgeons, current evidences from other countries support no such recommendations. ObjectiveTo determine whether dietary and physical restriction effectively lead to a decrease on postoperative complications of adenotonsillectomy in children when compared to no restriction. MethodsWe have designed a randomized clinical trial comparing two intervention: no specific counseling on diet or activity (Group A), and restriction recommendations on diet and physical activities (Group B). Caregivers completed a questionnaire on observed pain, diet and activity patterns, and medications administered. Parameters were compared at the 3rd and at the 7th postoperative day between intervention groups. ResultsWe have enrolled a total of 95 patients, 50 in Group A and 45 in Group B. Fourteen patients were lost to follow up. Eventually, 41 patients in group A and 40 in Group B were available for final analysis. Mean age in months (A=79.5; SD=33.9/B=81.1; SD=32.6) and sex (A=58% male; B=64.4% male) were equivalent between groups. Pain, evaluated through visual analog scale in the 3rd (A=2.0; IQR 1–6/B=4.5; IQR 2–6; p=0.18) and in the 7th (A=1.0; IQR 1.0–4.5/B=2.0; IQR 1.0–4.7; p=0.29) postoperative days, was not different between groups, as was the amount of analgesics administered. Dietary and physical activity patterns also showed no statistically significant differences between groups. ConclusionDietary and activity restriction after adenotonsillectomy does not seem to affect patients’ recovery. Such information may impact considerably on the social aspects that involve a tonsillectomy, reducing the working days lost by parents and accelerating the return of children to school.
Highlights
Culturally food and physical activity restriction are part of the routine postoperative care of many Brazilian surgeons, current evidences from other countries support no such recommendations
Children were allocated into two groups, no dietary and physical restrictions (Group A), and dietary and physical restrictions (Group B), by a simple randomization method
We found it necessary to reproduce a study in a Brazilian hospital similar to those conducted in institutions abroad, in order to discuss the impact of restrictive habits in our local population of children undergoing adenotonsillectomy
Summary
Culturally food and physical activity restriction are part of the routine postoperative care of many Brazilian surgeons, current evidences from other countries support no such recommendations. Adenotonsillectomy is a potential curative surgical procedure for patients presenting recurrent throat infections and Sleep-Disordered Breathing (SDB) which can both substantially affect child’s health status and Quality of Life (QoL).[1] The benefit of adenotonsillectomy in child’s QoL is well documented. Tonsillectomy may improve QoL by reducing throat infections, health care provider visits, and the need for antibiotic therapy. It improves sleep disturbance, vocal quality and cognitive and behavioral impairment in children.[2] Offsetting the benefits of tonsillectomy, surgery complications may include throat pain, postoperative nausea and vomiting, delayed feeding, voice changes, hemorrhage, and rarely death.[2]
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