An audit of post-operative analgesia in children following tonsillectomy

Area of Science:

• Pediatric Surgery
• Pain Management
• Anesthesiology

Background:

• Post-tonsillectomy pain is a significant and often underestimated issue in pediatric care.
• High proportions of children experience moderate to severe pain post-surgery, particularly upon ward return.

Purpose of the Study:

• To audit and improve post-operative pain management following pediatric tonsillectomy.
• To evaluate the effectiveness of revised pain management protocols.

Main Methods:

• Initial audit of post-operative pain in 33 children.
• Implementation of practice changes: pre-operative and uniform post-operative paracetamol and diclofenac, printed instructions, standardized nursing policy, and formal pain recording.
• Re-audit of pain in 100 children two years after protocol implementation.

Main Results:

• Significant reduction in moderate to severe pain upon ward return (70% to 48%).
• Decrease in maximum pain scores (85% to 56%) and pain scores at discharge (6% to 2%).
• Improved pain management outcomes demonstrated by the re-audit.

Conclusions:

• Standardized pain management protocols, including multimodal analgesia and clear administration guidelines, effectively reduce post-tonsillectomy pain in children.
• Formal pain assessment and standardized nursing practices are crucial for recognizing and managing pediatric post-operative pain.
• The study highlights the importance of addressing underestimated post-operative pain to improve patient outcomes.