Audit of pain management at home following tonsillectomy in children

Area of Science:

• Pediatric Surgery
• Pain Management
• Primary Care

Background:

• Tonsillectomy in children often results in significant post-operative pain.
• This pain places a considerable burden on primary care resources.
• Current pain management strategies may be insufficient.

Purpose of the Study:

• To audit the level of pain experienced by children after tonsillectomy.
• To assess the impact of pain on primary care utilization.
• To evaluate the effectiveness of revised post-tonsillectomy care protocols.

Main Methods:

• Initial audit using postal questionnaires in 52 pediatric tonsillectomy patients.
• Implementation of changes including 5-day discharge medication (paracetamol/ibuprofen or paracetamol/dihydrocodeine) and improved advice.
• Re-audit of 100 patients one year later to assess changes in pain and GP consultations.

Main Results:

• Initial audit revealed high rates of moderate to severe pain and 50% GP consultation for pain.
• Post-intervention, GP consultations reduced to 27%.
• Pain severity did not significantly decrease; paracetamol/ibuprofen showed superior analgesia over paracetamol/dihydrocodeine (p <0.05).

Conclusions:

• Revised discharge protocols, including specific analgesia regimens, can reduce primary care burden after pediatric tonsillectomy.
• Optimizing analgesic choice, such as favoring paracetamol/ibuprofen, is crucial for effective pain management.
• Further improvements in pain management strategies are warranted to reduce post-tonsillectomy pain severity.