[Postoperative comfort in pediatric outpatient tonsillectomy].
OBJECTIVE
Evaluate the comfort in children after ambulatory tonsillectomy, disregarding the surgical technique and with a systematic prescription of paracetamol and codeine. The study lasted 4 days including the day of surgery.


METHODS
[corrected] Prospective study during 5 months.


METHODS
We performed a prospective study over a five-month period to evaluate the comfort in children after ambulatory tonsillectomy. Opioids were used for analgesia during surgery, morphine and propacetamol in the recovery room, and a systematic prescription of paracetamol-codeine between Day 0 to Day 3 at home. The assessment of pain was made by nurses and the family, considering 6 endpoints: spontaneous pain and when swallowing by verbal scale (0 to 4), occurrence of PONV (0 or 1), quality of sleep (0 or 1), quality of feeding (0 or 1) and play (0 or 1), combined in a global score of 0 to 12, with a score < or = 4 very satisfactory.


RESULTS
78 children were included, 49 tonsillectomy by dissection, 29 by Sluder. The score were < or = 4 at Day 0 and Day 1 in 53 children, but statistical analysis (univariate analysis) showed difference between the two surgical procedures with a global comfort score better and PONV lower with dissection procedure.


CONCLUSIONS
The use of paracetamol-codeine after tonsillectomy offers a reliable analgesia with very satisfactory scores of comfort. Such prescription is effective in ambulatory tonsillectomy if a rigorous selection of patients is made.
Madadaki
C
C
Unité d'anesthésie-réanimation, hôpital pédiatrique Clocheville, CHU, 37044 Tours, France.
Laffon
M
M
Lesage
V
V
Blond
M H
MH
Lescanne
E
E
Mercier
C
C
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003061:Codeine / Q000627:therapeutic use; D004338:Drug Combinations; D004435:Eating / Q000187:drug effects / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009020:Morphine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000523:psychology*; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011446:Prospective Studies; D012890:Sleep / Q000187:drug effects; D014068:Tonsillectomy
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D004338:Drug Combinations; D000082:Acetaminophen; D009020:Morphine; D003061:Codeine