Abstract
PurposeTo explore the severity and duration of postoperative pain, the management of analgesics, and postoperative recovery in children undergoing tonsil surgery.MethodParticipants included 299 children aged 4–17 years undergoing tonsillotomy ± adenoidectomy (TT ± A) or tonsillectomy ± adenoidectomy (TE ± A). Data were collected up to 12 days. The child rated pain on the Face Pain Scale-Revised (FPS-R) and recovery using the Postoperative Recovery in Children (PRiC) questionnaire. Caregivers assessed their child's pain, anxiety, and nausea on a numeric analog scale and kept a log of analgesic administration.ResultsHigh pain levels (FPS-R ≥ 4) were reported in all surgical and age groups (TT ± A age 4–11, TE ± A age 4–11, TE ± A age 12–17), but there were variations in pain intensity and duration within and between groups. The TE ± A group scored more days with moderate to very excruciating pain and lower recovery than the TT ± A group, with the worst outcomes reported by older TE ± A children. The majority of the children used paracetamol + COX-inhibitors at home, but regular administration of analgesics was lacking, particularly during late evening and at night. Few were received rescue medication (opioid or clonidine) despite severe pain. Physical symptoms and daily life activities were affected during the recovery period. There was moderate agreement between child and the caregiver’s pain assessment scores.ConclusionChildren reported a troublesome recovery with significant postoperative pain, particularly older children undergoing tonsillectomy. Pain treatment at home was suboptimal and lacked regular analgesic administration. Patient information needs to be improved regarding the importance of regular administration of analgesics and rescue medication.
Highlights
The recovery period following pediatric tonsil surgery is long, approximately 14 days, but the time spent in the hospital is short [1]
The greatest number of days with Face Pain Scale-Revised (FPS-R) ≥ 4 was reported by children in the TE ± A age 12–17 group, followed by the TE ± A age 4–11 group, while the fewest number of days with FPS-R ≥ 4 was reported by children in the TT ± A age 4–11 group
The present study suggests that pain control after tonsil surgery could be improved
Summary
The recovery period following pediatric tonsil surgery is long, approximately 14 days, but the time spent in the hospital is short [1]. Well-established principles for successful management of postoperative pain include multimodal analgesia, adequate dosage, administration at regular intervals, use of appropriate route of administration [1, 4, 6], and complementary methods include different distraction techniques and consuming cold food or drink. Implementing these principles in home care places. To further optimize the care of these children, increased knowledge regarding postoperative pain and analgesic administration at home is necessary. The aim of this study was to explore the severity and duration of postoperative pain, the management of analgesics and postoperative recovery in children undergoing tonsil surgery
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