A comprehensive examination of the immediate recovery of children following tonsillectomy and adenoidectomy. (August 2020)

• Record Type: Journal Article
• Authors: Lao, Bryan K.; Kain, Zeev N.; Khoury, Dina; Jenkins, Brooke N.; Prager, Jeremy; Stevenson, Robert S.; Golianu, Brenda; Zuk, Jeannie; Gold, Jeffrey I.; Zhong, Qiu; Fortier, Michelle A.
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 135(2020:Aug.)
• Publication Date: 2020-08
• Subjects: Tonsillectomy -- Adenoidectomy -- Pediatric -- Recovery -- Ambulatory surgery -- Pain; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2020.110106
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Objectives: Using multiple well-validated measures and a large sample size, the goal of this paper was to describe the immediate clinical and behavioral recovery of children following tonsillectomy with or without an adenoidectomy (T&A) during the first two weeks following surgery. Study design: Observational, longitudinal study. Setting: Four major pediatric hospitals in the U.S. consisting of Children's Hospital of Orange County, Children's Hospital of Los Angeles, Lucile Packard Children's Hospital, and Children's Hospital Colorado. Subjects: and Methods : Participants included 827 patients between 2 and 15 years of age who underwent tonsillectomy with or without adenoidectomy surgery. Baseline and demographic information were gathered prior to surgery, and measures of clinical, behavioral, and physical recovery were recorded immediately following and up through two weeks after surgery. Results: Pain following T&A was clinically significant through the first post-operative week and nearly resolved by the end of the second week. Negative behavioral changes were highly prevalent after surgery (75.6% of children at Day 0) through the first week (63.9% at Week 1), and over 20% of children continued to evidence new onset negative behavioral changes at two weeks post-operatively. Children were rated as experiencing significant functional impairment in the immediate three days following surgery and most children returned to baseline functioning by the end of the second week. Conclusions: Results of this study suggest that children show immediate impairment in functioning and experience clinically significant pain throughout the first week following T&A, and new onset maladaptive behavioral changes persisting even up to the two-week assessment period.