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Published on: November 6, 2019

Pre-surgical child behavior ratings and pain management after two different techniques of tonsil surgery

Elisabeth Ericsson1, Marie Wadsby, Elisabeth Hultcrantz

  • 1Division of Otorhinolaryngology, Department of Neuroscience and Locomotion (INR), Faculty of Health Sciences, University of Linköping, SE-581 85 Linköping, Sweden. elier@inr.liu.se

International Journal of Pediatric Otorhinolaryngology
|July 4, 2006
PubMed

Insights

Tonsillectomy (TE) resulted in higher post-operative anxiety and pain compared to tonsillotomy (TT). Surgical method, not child behavior, predicted pain, and nurses underestimated pain levels in children undergoing tonsil surgery.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Child Psychology

Background:

  • Sleep-disordered breathing (SDB) can impact child behavior.
  • Understanding factors influencing post-tonsillectomy pain and anxiety is crucial for effective patient care.

Purpose of the Study:

  • To compare child behavior, pain, and anxiety between tonsillotomy (TT) and tonsillectomy (TE) surgical methods.
  • To investigate the relationship between previous surgeries/tonsillitis and current anxiety/pain levels.
  • To compare pain ratings among children, parents, and nurses.

Main Methods:

  • Ninety-two children (5-15 years) with SDB were randomized to TT or TE.
  • Child behavior was assessed using the Child Behavior Checklist (CBCL).
  • Anxiety was measured with the State-Trait-Anxiety Inventory for Children (STAIC), and pain with the Faces Pain Scale (FPS) and Verbal Pain Rating Scale (VPRS).

Main Results:

  • Children with SDB showed higher behavioral scores but no link to pain.
  • Post-operative anxiety correlated with pain, with the TE group reporting higher anxiety.
  • The TE group experienced more pain despite increased medication; nurses underestimated pain levels.

Conclusions:

  • Surgical technique (TE vs. TT) is a better predictor of post-operative pain than pre-operative child behavior.
  • Nurses' underestimation of pain highlights a potential gap in pain assessment.
  • SDB may affect behavior but not directly correlate with post-tonsillectomy pain outcomes.
Abstract

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