title: How to replace codeine after tonsillectomy in children under 12 years of age? Guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL).
abstract: The authors present the guidelines of the French Oto-rhino-laryngology--Head and Neck Surgery Society (SFORL) regarding pain management in children and adults following tonsillectomy. A multidisciplinary work group was entrusted with a literature review. Guidelines were drawn up based on the articles retrieved and the group members' experience. They were read over by an editorial group independent of the work group. A coordination meeting drew up the final version. Guidelines were graded A, B or C or as professional agreement in decreasing order of level of evidence. At home, non-steroid anti-inflammatory drugs (NSAIDs) are recommended in association with paracetamol in elevated respiratory risk and especially obstructive sleep apnea syndrome; in elevated hemorrhagic risk (hemostasis disorder, surgical problems, etc.), tramadol is recommended. Two other treatment schedules (modified NSAIDs and corticosteroids) have not undergone dedicated study and should be assessed. Management of post-tonsillectomy pain in children is founded on individual risk/benefit analysis.
authors.affiliation: Service d'anesthésie réanimation, hôpital Armand-Trousseau, 26, avenue du docteur-Netter, 75012 Paris, France. Electronic address: Isabelle.constant@trs.aphp.fr.
authors.forename: I
authors.initials: I
authors.lastname: Constant
authors.affiliation: Service d'ORL, chirurgie cervico-faciale et audiophonologie, HCL Groupement Hospitalier Est, hôpital Femme-Mère-Enfant (BRON), 59, boulevard Pinel, 69677 Bron cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Ayari Khalfallah
authors.affiliation: Cabinet d'ORL, centre médical Alpha 128, 128, avenue des Champs-Lasniers, 91940 Les Ulis, France.
authors.forename: A
authors.initials: A
authors.lastname: Brunaud
authors.affiliation: Service ORL et chirurgie cervico-faciale, hôpital Pontchaillou, CHU de Rennes, rue Henri-Le-Guilloux, 35033 Rennes, France.
authors.forename: V
authors.initials: V
authors.lastname: Deramoudt
authors.affiliation: Service ORL et consultation chirurgique pédiatrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Fayoux
authors.affiliation: Service ORL et chirurgie cervico-faciale, CHU Timone, 264, rue St-Pierre, 13385 Marseille cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Giovanni
authors.affiliation: Centre de la douleur chronique, CHU La Timone, 264, rue St-Pierre, 13385 Marseille cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Mareau
authors.affiliation: Service ORL et chirurgie cervico-faciale, CHRU de Brest, 5, avenue Foch, 29200 Brest, France.
authors.forename: R
authors.initials: R
authors.lastname: Marianowski
authors.affiliation: Service ORL et chirurgie cervico-faciale, CHU Timone, 264, rue St-Pierre, 13385 Marseille cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Michel
authors.affiliation: Service ORL et chirurgie cervico-faciale, CHU de Montpellier, 34295 Montpellier cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Mondain
authors.affiliation: Service ORL et chirurgie cervico-faciale, CHU Timone, 264, rue St-Pierre, 13385 Marseille cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Paganelli
authors.affiliation: Service ORL et chirurgie cervico-faciale pédiatrique, hôpital Clocheville, boulevard Beranger, 37000 Tours, France.
authors.forename: S
authors.initials: S
authors.lastname: Pondaven
authors.affiliation: Service ORL et chirurgie cervico-faciale, CHU Hautepierre, 1, avenue Maline, 67098 Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Schultz
authors.affiliation: Faculté et université Paris Descartes, rue de l'école-de-medecine, 75006 Paris, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Treluyer
authors.affiliation: Centre de prise en charge de la douleur chronique, CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France.
authors.forename: C
authors.initials: C
authors.lastname: Wood
authors.affiliation: Service ORL et chirurgie cervico-faciale, CHU Timone, 264, rue St-Pierre, 13385 Marseille cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Nicolas
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003061:Codeine / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D059408:Pain Management / Q000592:standards*; D010149:Postoperative Pain / Q000188:drug therapy*; D018570:Risk Assessment; D014068:Tonsillectomy / Q000009:adverse effects*
chemical_list: D000700:Analgesics; D003061:Codeine
keywords: Analgesia; Anti-inflammatories; Codeine; Corticosteroids; Hemorrhage; Obstructive sleep apnea; Pain; Respiratory depression; Tonsillectomy; Vomiting