title: Korean hand therapy for tonsillectomy pain in children.
abstract: OBJECTIVE
  Severe throat pain can result from tonsillectomy and last up to 10 days in children. Codeine has recently been banned by the FDA in light of a recently recognized risk of death in these patients. Acupuncture has previously been associated with decreased pain in children after tonsillectomy. However, about 1 in 5 patients will refuse traditional acupuncture because of fear of needles. We explored Korean Hand Therapy (KHT), an acupuncture technique which does not involve needles, to see if this would also be associated with pain relief and be more widely accepted by children.
  
  
  METHODS
  This was a retrospective review of children who underwent tonsillectomy over a 4-month window. No narcotics were prescribed after surgery. Patients who wanted help with pain relief were offered KHT. Perceived pain level was assessed before and after the KHT treatment. Following the 10-day recovery for tonsillectomy, patients or their parents were queried as to how long the pain relief from the KHT intervention was perceived to last.
  
  
  RESULTS
  Fifty-six children underwent tonsillectomy; 29 of these patients (1-14 years) presented for pain relief after tonsillectomy and received KHT. 100% of patients (29 of 29) who were offered KHT accepted the intervention. The mean reported pain level before KHT was 5.03 (SD=2.69) out of 10. This fell to 3.06 (SD=3.15) after KHT. Statistical analyses supported the general conclusion that pain reports decline after KHT in the sampled population. 15 patients who received KHT - or their parents - provided a post-recovery report for how long they believed the KHT intervention lasted. The mean duration of perceived KHT benefit was 78.20h, though the standard deviation was large (64.38h). With the exception of one child reporting a slight increase in pain, no adverse effects were associated with KHT.
  
  
  CONCLUSIONS
  The data tentatively suggest KHT is associated with decreases in perceived pain after tonsillectomy and is widely accepted by children. These data - combined with the cost effectiveness, safety and ease of administering KHT - suggest that further studies exploring the effectiveness of KHT for pain relief after tonsillectomy are merited.
authors.affiliation: The Northern Navajo Medical Center, PO Box 160, Hwy 491 North, Shiprock, NM 87420, USA. Electronic address: jochi@integrativeENT.com.
authors.forename: James W
authors.initials: JW
authors.lastname: Ochi
mesh_terms: D019050:Acupressure; D015670:Acupuncture Therapy / Q000379:methods*; D000233:Adenoidectomy / Q000009:adverse effects; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D010612:Pharyngitis / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects*
keywords: Acupuncture; Children; Codeine; Korean hand therapy; Pain; Tonsillectomy