Perianesthesia nurses' pain management after tonsillectomy and adenoidectomy: pediatric patient outcomes

Area of Science:

• Pediatric Anesthesiology
• Pain Management
• Surgical Recovery

Background:

• Tonsillectomy and adenoidectomy (T and A) is a common pediatric surgical procedure associated with significant postoperative pain.
• Effective pain management is crucial for recovery, influencing patient comfort and oral intake.

Purpose of the Study:

• To compare the effectiveness of five different postanesthesia analgesic regimens.
• To evaluate the impact of these treatments on pain intensity, nausea, vomiting, and oral fluid intake in pediatric patients undergoing T and A.

Main Methods:

• A descriptive-comparative study involving 92 pediatric patients (3-18 years old) undergoing T and A.
• Patients received one of five postoperative analgesic treatments: IV fentanyl, IV fentanyl + oral analgesic, IV morphine, IV morphine + oral analgesic, or oral analgesics alone.
• Pain scores, nausea/vomiting incidence, and oral fluid intake were assessed.

Main Results:

• No significant differences in pain scores, nausea/vomiting incidence, or oral intake were observed across the five analgesic groups.
• 29% of patients experienced nausea and vomiting, but all achieved adequate oral fluid intake before discharge.
• Nurses administered more morphine equivalents to patients reporting pain in Phase I recovery.
• Low pain scores were reported at discharge from both Phase I and Phase II recovery, despite challenges in pain assessment.

Conclusions:

• Varied analgesic approaches provided adequate pain control for pediatric patients after T and A.
• Individualized pain medication titration is essential, as pain relief requirements differ among children.
• Further research may be needed to address challenges in pediatric pain assessment in the recovery setting.