Postoperative pain, nausea and vomiting following adeno‐tonsillectomy – a long‐term follow‐up

Stanko, Dana; Bergesio, R.; Davies, Kylie; Hegarty, Mary; Ungern‐Sternberg, Britta S. von

doi:10.1111/pan.12170

Cited by 77 publications

(68 citation statements)

References 9 publications

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“…Here, ear-nose-throat (ENT) procedures have been looked at in detail; eg, after adenotonsillectomy, 52% of children had a pain score .5/10 on day 3 and 30% on day 7. 8 It is of note here that in a comparison of day-stay versus overnight inpatient stay, pain scores during the first 24 hours were only slightly increased for day-stay patients, and that the maximum pain scores at 24 hours and 7 days were similar. 9 This is contradicted by another audit, which found pain reports to be significantly higher at home than in the hospital.…”

Section: Quality Of Pain Relief After Ambulatory Surgerymentioning

confidence: 93%

Postoperative pain management following ambulatory anesthesia: challenges and solutions

Schug¹,

Chandrasena²

2015

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Worldwide, there is an increasing trend toward performing more and more complex surgery in an ambulatory setting, partially driven by economic considerations. Provision of appropriate pain relief is still often inadequate in this setting; poor pain control and adverse effects of opioids provided for pain control are common reasons for readmission, with human and economic consequences. Therefore, improved analgesia after ambulatory surgery is an important goal; appropriate strategies include identification of at-risk patients, provision of multimodal analgesia, and early use of rescue strategies. Multimodal analgesia is based on the combined use of multiple medications or techniques for pain control, which have different mechanisms of action or act on different sites at the pain pathways. Thereby, such an approach improves analgesia, reduces opioid requirements, and reduces adverse effects of opioids. Important components of multimodal analgesia are nonopioids (acetaminophen and anti-inflammatory drugs), corticosteroids, and alpha-2-delta modulators (gabapentin, pregabalin), but most importantly the use of local and regional anesthesia techniques. Here, the use of adjuvants is one way to increase the duration of pain relief, but, increasingly, continuous peripheral nerve blocks via catheters are used in ambulatory patients, too. Finally, the planning of discharge medications needs a balancing act between the requirements for provision of good analgesia and the risk of opioids going out into the community.

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Section: Quality Of Pain Relief After Ambulatory Surgerymentioning

confidence: 93%

Postoperative pain management following ambulatory anesthesia: challenges and solutions

Schug¹,

Chandrasena²

2015

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“…Surprisingly, beneath the high pain scores after orthopedic surgery, tonsillectomy and appendectomy are associated with quite similar pain scores. Up to 44% of children suffered from severe pain [visual analog scale (VAS) >5] after tonsillectomy on the third postoperative day, and up to 30% on day 7 [16]. Another publication described similar pain scores during the first 7 days after tonsillectomy, with many children still experiencing clinically significant levels of pain throughout the second week of recovery [17 && ].…”

Section: Andandmentioning

confidence: 99%

What's new in pediatric acute pain therapy?

Schultz-Machata

Weiß

Becke

2014

Current Opinion in Anaesthesiology

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PURPOSE OF REVIEW This review highlights the current trends of efficient and safe perioperative pediatric pain therapy in the context of a multimodal pain therapy concept. RECENT FINDINGS A multimodal pain therapy concept should be easy to apply and safe regarding the occurrence of sideeffects. The administration of nonopioid analgesics should be obligatory, regional anesthesia techniquesunder ultrasound guidance -should be performed whenever possible, opioids should be given immediately and sufficiently whenever necessary, the administration of co-analgesics like lidocaine, dexamethasone or ketamine should be considered, and most importantly, each pain therapy should be performed according to pain assessment and long enough until adequate pain relief. SUMMARY Safe and simple pediatric pain management in the perioperative period combines not only easy to apply and safe stepwise pain therapy itself, but also adequate pain assessment and the implementation of continuous hospital quality improvement strategies. Purpose of reviewThis review highlights the current trends of efficient and safe perioperative pediatric pain therapy in the context of a multimodal pain therapy concept. Recent findingsA multimodal pain therapy concept should be easy to apply and safe regarding the occurrence of side-effects. The administration of nonopioid analgesics should be obligatory, regional anesthesia techniques -under ultrasound guidance -should be performed whenever possible, opioids should be given immediately and sufficiently whenever necessary, the administration of co-analgesics like lidocaine, dexamethasone or ketamine should be considered, and most importantly, each pain therapy should be performed according to pain assessment and long enough until adequate pain relief. SummarySafe and simple pediatric pain management in the perioperative period combines not only easy to apply and safe stepwise pain therapy itself, but also adequate pain assessment and the implementation of continuous hospital quality improvement strategies.

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“…There is increasing evidence from several studies suggesting pain is inadequately managed in the home environment and can potentially delay recovery with long‐term consequences including alterations in the development and function of the nervous system and pain perception . Furthermore, re‐presentations to health‐care professionals and emergency departments because of inadequate pain relief represent an increasingly common cause for readmission to hospital …”

mentioning

confidence: 99%

Is day surgery failing our children?

Mishra

Foley

Rutledge

et al. 2015

J Paediatrics Child Health

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Postoperative pain, nausea and vomiting following adeno‐tonsillectomy – a long‐term follow‐up

Abstract: Adenotonsillectomy is associated with significant pain and PONV, persisting into the seventh postoperative day. Parental education and information seems inadequate and needs to be improved.

Cited by 77 publications

References 9 publications

Postoperative pain management following ambulatory anesthesia: challenges and solutions

Postoperative pain management following ambulatory anesthesia: challenges and solutions

What's new in pediatric acute pain therapy?

Is day surgery failing our children?

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