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Updated: Dec 7, 2025
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Postoperative pain, pain management, and recovery at home after pediatric tonsil surgery
Fredrik Alm1, Stefan Lundeberg2, Elisabeth Ericsson3
1Department of Anaesthesia and Intensive Care, School of Health Sciences, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden. fredrik.alm@oru.se.
Insights
Children undergoing tonsil surgery experience significant pain, with suboptimal pain management at home. Older children, especially after tonsillectomy, face more severe pain and slower recovery, highlighting the need for improved analgesic strategies.
Area of Science:
- Pediatric surgery
- Pain management
- Postoperative recovery
Background:
- Tonsil surgery is common in children.
- Postoperative pain significantly impacts recovery.
- Effective pain management is crucial for pediatric patients.
Purpose of the Study:
- To investigate postoperative pain severity and duration in children after tonsil surgery.
- To evaluate analgesic management strategies.
- To assess the impact on postoperative recovery.
Main Methods:
- 299 children (aged 4-17) undergoing tonsillotomy ± adenoidectomy (TT±A) or tonsillectomy ± adenoidectomy (TE±A) were studied for up to 12 days.
- Children used the Face Pain Scale-Revised (FPS-R) for pain and Postoperative Recovery in Children (PRiC) for recovery.
- Caregivers reported pain, anxiety, and nausea via numeric analog scale and logged analgesic use.
Main Results:
- All groups reported high pain levels, with TE±A patients experiencing more severe pain and poorer recovery, especially older children.
- Most children used paracetamol + COX-inhibitors, but regular administration, particularly at night, was lacking.
- Rescue medication was rarely used despite severe pain, and physical symptoms affected daily activities.
Conclusions:
- Children experience significant postoperative pain and troublesome recovery after tonsil surgery, particularly older children undergoing tonsillectomy.
- Home-based pain treatment was suboptimal, with inadequate regular analgesic administration.
- Enhanced patient education on regular analgesic and rescue medication use is necessary.
Purpose:
To explore the severity and duration of postoperative pain, the management of analgesics, and postoperative recovery in children undergoing tonsil surgery.
Method:
Participants included 299 children aged 4-17 years undergoing tonsillotomy ± adenoidectomy (TT ± A) or tonsillectomy ± adenoidectomy (TE ± A). Data were collected up to 12 days. The child rated pain on the Face Pain Scale-Revised (FPS-R) and recovery using the Postoperative Recovery in Children (PRiC) questionnaire. Caregivers assessed their child's pain, anxiety, and nausea on a numeric analog scale and kept a log of analgesic administration.
Results:
High pain levels (FPS-R ≥ 4) were reported in all surgical and age groups (TT ± A age 4-11, TE ± A age 4-11, TE ± A age 12-17), but there were variations in pain intensity and duration within and between groups. The TE ± A group scored more days with moderate to very excruciating pain and lower recovery than the TT ± A group, with the worst outcomes reported by older TE ± A children. The majority of the children used paracetamol + COX-inhibitors at home, but regular administration of analgesics was lacking, particularly during late evening and at night. Few were received rescue medication (opioid or clonidine) despite severe pain. Physical symptoms and daily life activities were affected during the recovery period. There was moderate agreement between child and the caregiver's pain assessment scores.
Conclusion:
Children reported a troublesome recovery with significant postoperative pain, particularly older children undergoing tonsillectomy. Pain treatment at home was suboptimal and lacked regular analgesic administration. Patient information needs to be improved regarding the importance of regular administration of analgesics and rescue medication.
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