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Children's pain at home following (adeno) tonsillectomy
Jan P H Hamers1, Huda Huijer Abu-Saad
1Section of Nursing Science, University of Maastricht, Maastricht, The Netherlands. jph.hamers@zw.unimaas.nl
Insights
Children undergoing tonsillectomies experience significant post-operative pain at home. Pain management and related issues like eating and sleep require improvement for better pediatric recovery.
Area of Science:
- Pediatric Surgery
- Pain Management
- Otolaryngology
Background:
- Post-operative pain is a significant concern in pediatric surgical patients.
- Effective pain management is crucial for recovery and preventing complications.
Purpose of the Study:
- To evaluate the prevalence and severity of children's pain at home after (adeno)tonsillectomies.
- To identify pain-related problems and assess the adequacy of pain management.
Main Methods:
- Parents of 161 children undergoing myringotomy, adenoidectomy, or (adeno)tonsillectomy assessed pain using a Visual Analogue Scale (VAS).
- Phone interviews were conducted with parents of (adeno)tonsillectomy patients on day 7 post-operation.
Main Results:
- Mean VAS pain scores were significantly higher for (adeno)tonsillectomy (22.1) compared to adenoidectomy (10.6) and myringotomy (3.2) groups.
- 81% of parents reported their child experienced pain at home, but analgesics were not always administered.
- Pain led to problems with eating, fluid intake, vomiting, and sleep disturbance; 67% of children recalled severe hospital pain.
Conclusions:
- Children undergoing (adeno)tonsillectomies suffer clinically significant home pain.
- Pain management strategies and addressing related issues need substantial improvement for pediatric patients.
Abstract:
The aim of this study was to evaluate the prevalence and severity of children's pain at home following (adeno)tonsillectomies. The subjects were parents of 161 children (86 boys, 75 girls) undergoing myringotomies, adenoidectomies and (adeno)tonsillectomies. The mean age of the children was 5.5 years (SD=2.4; range 1-14). Parents were asked to assess the child's average pain on the day of operation and 7 days after the operation, using a 100 mm Visual Analogue Scale (VAS). Parents from (adeno)tonsillectomy patients were also interviewed by phone on day 7.The mean VAS pain intensity scores by period (day of operation until 7th day after operation) differed between the myringotomy (3.2), adenoidectomy (10.6), and (adeno)tonsillectomy (22.1) group (F(2,133)=31.65; p<0.001). The VAS ratings were highest for the tonsillectomy group (p<0.001). There was a trend that pain intensity scores for adenoidectomies were significantly higher than scores for myringotomies (p=0.07). In the interviews, 81% of the parents stated that their child suffered pain at home. However, this was not necessarily a reason to administer an analgesic. Furthermore, parents reported pain-related problems like problems regarding eating, fluid intake, vomiting and sleep disturbance. Finally, 67% of the children at home recalled severe pain experience in the hospital. It was concluded that especially following (adeno)tonsillectomies children suffer clinically significant pain at home and that the management of pain and related problems needs to be clearly improved.