The severity and duration of postoperative pain and analgesia requirements in children after tonsillectomy, orchidopexy, or inguinal hernia repair.
OBJECTIVE
To provide parents of children with accurate information regarding postoperative pain, its management, and functioning following common surgical procedures.


BACKGROUND
The increasing prevalence of pediatric day-case procedures demands a more thorough understanding of the recovery profiles associated with these operations.


OBJECTIVE
To document postdischarge pain profiles, analgesia requirements, and functional limitation in children following tonsillectomy, orchidopexy, or inguinal hernia repair (IHR).


METHODS
Following hospital discharge, parents were asked to record their children's pain levels, analgesia consumption, and degree of functional limitation each day until complete recovery. Pain and functional limitation were measured using the Parents' Postoperative Pain Measurement (PPPM) scale and Functional Activity Score, respectively. Significant pain was defined as PPPM ≥ 6.


RESULTS
One hundred and five patients (50, tonsillectomy; 24, orchidopexy; and 31, IHR) were recruited. Median PPPM was always <6 after IHR, ≥6 only on day 1 after orchidopexy and persisted through to day 8 after tonsillectomy. Mild or severe functional limitation was observed after all surgeries and persisted for 4, 5, and 4 days after median PPPM < 6 after IHR, orchidopexy, and tonsillectomy, respectively. Combination analgesia was commonly administered after orchidopexy and tonsillectomy but less so after IHR. The general practitioner consultation rate following tonsillectomy was 54%.


CONCLUSIONS
After tonsillectomy, children experience significant pain and severe functional limitation for 7 days after surgery. For many children, pain and functional limitation persists throughout the second postoperative week. In children undergoing orchidopexy, paracetamol and ibuprofen provide adequate analgesia. Pain begins to subside after the first postoperative day, and normal activity resumes after 7 days. After IHR, children experience mild pain that can be treated with paracetamol and return to normal functioning after 4 days.
University of Melbourne, Melbourne, Vic., Australia.
David W
DW
Stewart
Philip G
PG
Ragg
Suzette
S
Sheppard
George A
GA
Chalkiadis
D000233:Adenoidectomy / Q000009:adverse effects; D000700:Analgesics / Q000008:administration & dosage* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D056126:Orchiopexy / Q000009:adverse effects*; D059408:Pain Management; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D014068:Tonsillectomy / Q000009:adverse effects*
D000700:Analgesics