Characterization of pain in the first two weeks after tonsillectomy in children 3 to 8 years old. A pilot study

  1. Juan Manuel Granados-Sitges 1
  2. Alex Ramírez-Rosa 1
  3. José Granell 2
  4. Javier Hernández-Calvín 3
  1. 1 Servicio de Otorrinolaringología. Hospital Universitario Rey Juan Carlos. Móstoles. Madrid. España
  2. 2 Facultad de Ciencias Biomédicas y de la Salud. Universidad Europea de Madrid. Villaviciosa de Odon. Madrid
  3. 3 Servicio de Otorrinolaringología. Hospital Universitario Quirónsalud Madrid. Pozuelo. Madrid. España
Show affiliations +
Journal:
Revista ORL

ISSN: 2444-7986,  2444-7986

Year of publication: 2022

Volume: 13

Issue: 3

Pages: 203-210

Type: Article

DOI: 10.14201/ORL.28188 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: Revista ORL

Abstract

Introduction and objective: To study the pain in children is a challenge. Tonsillectomy is a very common and painful surgical procedure in which there are still barriers to warrant an adequate pain management. The purpose of this study is to characterize the pain after surgery in children between 3 and 8 years-old who underwent tonsillectomy. Method: We performed a descriptive, observational and prospective study in children aged 3 to 8 who underwent tonsillectomy. The data collection was made through a pain questionnaire based in the intensity of pain from 0-10 in the Wong Baker scale (based on drawn faces). Parents also fulfilled other questions about the days that the children could not attend the school and the working days that the parents themselves lost. The analgesic treatment that each child received was also recorded. Results: Twenty-nine patient were included, 14 girls and 15 boys with a median age of 4. The highest level of pain was found the second day with a median value of 3,0. This second day was so chosen to compare the level of pain between indications. The median pain was 3,0 when it was for obstructive disease, but 4,0 when obstruction was associated with facial growth disorders. Children lost a median of 8 days at school and their parents 2 days at work each one. Discussion: Our limited data suggest that the long-term side effects of the upper airway obstruction due to tonsillar hypertrophy like disorders of facial growth made the surgery more painful and that the pain had in our environment a greater impact in patients and their parents lifes. It appears to be important to stablish a scheduled analgesic treatment for the first 10 days after surgery.

Bibliographic References

  • Vons KMJ, Bijker JB, Verwijs EW, Majoor MHJM, De Graaff JC. Postoperative pain during the first week after adenoidectomy and guillotine adenotonsillectomy in children. Paediatr Anaesth. 2014;24(5):476–82.
  • Macaya Martínez A, Arruti González I, Quer Canut S. Amigdalectomía y adenoidectomía. Indicaciones, técnicas y complicaciones. Libr virtual Form en ORL. 2014;1–15.
  • Gozal D, Tan H-L, Kheirandish-Gozal L. Obstructive sleep apnea in children: a critical update. Nat Sci Sleep. 2013 Sep;109.
  • Mechanisms and predisposing factors for sleep-related breathing disorders in children - UpToDate [Internet]. [cited 2020 Feb 23]. Available from: https://www-uptodate-com.ezproxy.universidadeuropea.es/contents/mechanisms-and-predisposing-factors-for-sleep-related-breathing-disorders-in-children?sectionName=Enlargedtonsilsandadenoids&search=osachildren&topicRef=6363&anchor=H12&source=see_link#H12
  • Hanlon CE, Binka E, Garofano JS, Sterni LM, Brady TM. The association of obstructive sleep apnea and left ventricular hypertrophy in obese and overweight children with history of elevated blood pressure. J Clin Hypertens [Internet]. 2019 Jul 1 [cited 2020 Feb 23];21(7):984–90. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31222948
  • Cognitive and behavioral consequences of sleep disorders in children - UpToDate [Internet]. [cited 2020 Feb 23]. Available from: https://www-uptodate-com.ezproxy.universidadeuropea.es/contents/cognitive-and-behavioral-consequences-of-sleep-disorders-in-children?sectionName=Sleep-relatedbreathingdisorders&search=osachildren&topicRef=6373&anchor=H16053990&source=see_link#H16053990
  • Adenotonsillectomy for obstructive sleep apnea in children - UpToDate [Internet]. [cited 2020 Feb 23]. Available from: https://www-uptodate-com.ezproxy.universidadeuropea.es/contents/adenotonsillectomy-for-obstructive-sleep-apnea-in-children?search=osachildren&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4
  • De Luca Canto G, Pachêco-Pereira C, Aydinoz S, Bhattacharjee R, Tan H-L, Kheirandish-Gozal L, et al. Adenotonsillectomy Complications: A Meta-analysis. Pediatrics [Internet]. 2015 Oct 1 [cited 2020 Feb 23];136(4):702–18. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26391937
  • Tonsillectomy (with or without adenoidectomy) in children: Postoperative care and complications - UpToDate [Internet]. [cited 2020 Feb 23]. Available from: https://www-uptodate-com.ezproxy.universidadeuropea.es/contents/tonsillectomy-with-or-without-adenoidectomy-in-children-postoperative-care-and-complications?sectionName=COMPLICATIONS&search=osachildren&topicRef=97855&anchor=H7658117&source=see_link#H7658117
  • Longo D, Fauci A, Kasper D, Hauser S, Jameson L, Loscalzo J. Harrison: principios de medicina interna (18° ed). In: Harrison Principios de Medicina interna. 2012.
  • Evaluation and management of pain in children - UpToDate [Internet]. [cited 2019 Oct 22]. Available from: https://www-uptodate-com.ezproxy.universidadeuropea.es/contents/evaluation-and-management-of-pain-in-children?search=approachto evaluation of pain in children&source=search_result&selectedTitle=9~150&usage_type=default&display_rank=9#H3
  • Young JR, Sih C, Hogg MM, Anderson-Montoya BL, Fasano HT. Qualitative Assessment of Face Validity and Cross-Cultural Acceptability of the Faces Pain Scale: “Revised” in Cameroon. Qual Health Res [Internet]. 2018 Apr 1 [cited 2020 Feb 23];28(5):832–43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29571279
  • Bawa M, Mahajan JK, Aggerwal N, Sundaram J, Rao KLN. Barriers to Pediatric Pain Management in Children Undergoing Surgery: A Survey of Health Care Providers. J Pain Palliat Care Pharmacother [Internet]. 2015 Oct 2 [cited 2020 Feb 23];29(4):353–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26654407
  • Dorkham MC, Chalkiadis GA, Von Ungern Sternberg BS, Davidson AJ. Effective postoperative pain management in children after ambulatory surgery, with a focus on tonsillectomy: Barriers and possible solutions. Vol. 24, Paediatric Anaesthesia. 2014. p. 239–48.
  • Brasher C, Gafsous B, Dugue S, Thiollier A, Kinderf J, Nivoche Y, et al. Postoperative pain management in children and infants: An update. Pediatr Drugs. 2014;16(2):129–40.
  • Salario anual medio, mediano, modal, a tiempo completo y a tiempo parcial, por periodo.(10882) [Internet]. [cited 2020 Mar 29]. Available from: https://www.ine.es/jaxiT3/Datos.htm?t=10882#!tabs-tabla
Data source: Dialnet