PURPOSE: The undertreatment of pediatric pain has been widely researched and continues to be a concern for health care professionals. Adenotonsillectomy is a common pediatric surgery associated with a moderate-to-high level of postoperative pain. The purpose of this study was to increase understanding of the current pain management practices provided to children aged 5 to 10 years undergoing adenotonsillectomy and identify areas for improvement. DESIGN: A retrospective descriptive design was used. METHODS: An extensive review of the literature on pediatric pain management after adenotonsillectomy provided the evidence to compare against the care currently provided at our institution. A retrospective chart review of 100 children who have undergone outpatient adenotonsillectomy surgery over a 6-month period was conducted. FINDINGS: Patients who received combination opioid analgesic medications either intraoperatively or during Phase I had significantly lower pain scores in Phase II than those who received monotherapy in either setting. CONCLUSIONS: The combination of drug therapy and parental presence may be helpful in decreasing pain and postanesthesia care unit length of stay. Exploration of the role of nonpharmacologic pain management techniques such as distraction, guided imagery, music, and the use of ice collars in conjunction with analgesic therapy is needed.
PURPOSE: The undertreatment of pediatric pain has been widely researched and continues to be a concern for health care professionals. Adenotonsillectomy is a common pediatric surgery associated with a moderate-to-high level of postoperative pain. The purpose of this study was to increase understanding of the current pain management practices provided to children aged 5 to 10 years undergoing adenotonsillectomy and identify areas for improvement. DESIGN: A retrospective descriptive design was used. METHODS: An extensive review of the literature on pediatric pain management after adenotonsillectomy provided the evidence to compare against the care currently provided at our institution. A retrospective chart review of 100 children who have undergone outpatient adenotonsillectomy surgery over a 6-month period was conducted. FINDINGS:Patients who received combination opioid analgesic medications either intraoperatively or during Phase I had significantly lower pain scores in Phase II than those who received monotherapy in either setting. CONCLUSIONS: The combination of drug therapy and parental presence may be helpful in decreasing pain and postanesthesia care unit length of stay. Exploration of the role of nonpharmacologic pain management techniques such as distraction, guided imagery, music, and the use of ice collars in conjunction with analgesic therapy is needed.